Wpływ migotania przedsionków na przebieg kliniczny i leczenie pacjentów z niewydolnością serca — dane z wieloośrodkowego rejestru

Abstract

Introduction. When heart failure (HF) and atrial fibrillation (AF) afflict the same patient simultaneously, it becomes a challenge for cardiologists. This is not only due to the need to intensify preventive measures to reduce the prevalence of common aetiological factors, but also due to growing healthcare costs, particularly care costs for elderly patients at high risk of accumulated complications of both diseases. Our study was aimed at evaluating the concomitant incidence of AF on the natural history and treatment of Polish HF patients on the basis of data obtained in a multicentre registry study. Material and methods. In this study, the population subjected to retrospective analysis consisted of Polish patients included in the long-term ESC-HF registry study (N = 1,126). A comparative analysis of the study group (AF+) and the control group (AF−) was carried out. Results . No differences were observed in the rates of in-hospital deaths between the (AF+) and the (AF−) group: 2.9% versus 2.8%, [p = not significant (NS)]. The average duration of hospitalisation in the AF+ group was 9.8 ± 14.7 days compared to 8.8 ± 10.9 days in the AF− group (p = NS). In the AF+ group, compared to the AF− group, significantly higher frequencies were recorded for the following parameters: exacerbation of chronic HF as the cause of hospitalisation, intravenous diuretics usage during hospitalisation, electrical cardioversion, as well as in-hospital use of mineralocorticoid receptor antagonists, diuretics, digoxin, oral antithrombotic agents and amiodarone. Conclusions. In the population of HF patients requiring hospitalisation, the AF+ subgroup is characterised by poorer clinical condition (biventricular cardiac decompensation, lower systolic blood pressure, higher heart rate on admission, and more frequent use of intravenous diuretics). The concomitance of AF significantly impacts the natural history and treatment of HF patients.