Heart failure & cardiomyopathies
Atrial electrofunctional predictors of incident atrial fibrillation in cardiac amyloidosis
Authors' conclusion
In patients with CA, older age, IAB on 12-lead electrocardiography, and reduced LAEF on cardiac magnetic resonance imaging are significant and independent predictors of incident AF.
Study context
- Population
- Sinus rhythm patients with AL or ATTR cardiac amyloidosis undergoing ECG and CMRAL-CA 40
- Participants
- 96 patients
- Exposure
- Patients with incident atrial fibrillation (AF) vs without AF
- AFn = 30
- Outcome
- New-onset AF
- Follow-up
- 18-month median (Q1-Q3, 7-29 months)
Methodological detailsmulticentre, 4 cardiac amyloidosis (CA) referral centres, observational
- Multicentre
- 4 CA referral centres
- Observational
Main finding
As reported in the abstract
Incident AF · 18-month median follow-up
Hazard ratio (95% CI)P value
Age
1.059(1.002–1.118)
P = 0.042Any type of IAB
2.211(1.03–4.75)
P = 0.041LAEF
0.967(0.936–0.998)
P = 0.044- Incident AF
- 30 patients (29%)
Observational data: associations, not effects.
Further findings
Characteristics, AF vs no AF
- Age, years: 79 vs 73
- P = 0.001
- ATTR: 87% vs 45%
- P < 0.001
- Partial interatrial block (IAB): 47% vs 21%
- P = 0.011
- Advanced IAB: 17% vs 3%
- P = 0.017
- Left atrial ejection fraction (LAEF): 29% vs 41%
- P = 0.004
Cumulative AF incidence by number of risk factors (any IAB, LAEF <40%, age >78 years) · 12 months
- All 3 risk factors
- 40%
- 1 risk factor
- 8.5%
- No risk factors
- 7.6%
- Risk with all 3 significantly higher
Original publication
Atrial electrofunctional predictors of incident atrial fibrillation in cardiac amyloidosis. Heart Rhythm. Published 2 February 2024. doi:10.
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