Development of Congestive Heart Failure in Japanese Patients With Atrial Fibrillation

Abstract

Atrial fibrillation (AF) and congestive heart failure (CHF) are frequently coexistent, but their temporal relationship in Japanese patients is unclear. 248 AF patients (63.6+/-10.0 years old) without a history of CHF were enrolled for analysis of the development of CHF during the follow-up period of 49.7+/-29.8 months. Of them, 195 did not have structural heart disease, 22 had dilated or hypertrophic cardiomyopathy, 18 had an old myocardial infarction, and 15 had valvular heart disease. During the follow-up period, 16 patients (6.5%) developed CHF requiring hospitalization (2.0% per patient-year). Although age, gender, fractional shortening, left atrial diameter, hypertension and diabetes mellitus were not associated with CHF development, existence of structural heart disease and left ventricular hypertrophy by Cornell voltage criteria on ECG were significantly associated with CHF development. Cox-Hazard regression analysis revealed that the existence of structural heart disease was the only independent risk factor (hazard ratio 3.50, 95% confidence interval 1.21-10.1). In the present group of Japanese AF patients, CHF requiring hospitalization occurred at a rate of 2% per year. The existence of structural heart disease was the only independent risk factor in this population.