Arrhythmias & electrophysiologyMeta-analysis
Major clinical outcomes in symptomatic vs. asymptomatic atrial fibrillation: a meta-analysis
- Systematic review and meta-analysis
- random-effects
Medline, Cochrane Library and Scopus searched until 25 March 2024
Authors' conclusion
The risk of major clinical outcomes did not differ between individuals with and without AF-related symptoms. Asymptomatic patients had a greater hazard of progression to permanent AF.
Study context
- Population
- Patients with atrial fibrillation (AF)
- Participants
- 217,850 patients · 36 studies
- Comparison
- Symptomatic vs asymptomatic AF
Pooled result
As reported in the abstract
Major clinical outcomes (frequentist analysis)
Symptomatic vs AsymptomaticHazard ratio (95% CI)
new-onset HF
1.33(1.19–1.49)
HR
- all-cause mortality
- .97 (95% CI .80-1.17)
- CV mortality
- 1.04 (95% CI .72-1.49)
- thromboembolism
- 1.06 (95% CI .87-1.28)
- stroke
- 1.06 (95% CI .84-1.34)
- hospitalization
- 1.34 (95% CI .89-2.02)
- MI
- .98 (95% CI .70-1.36)
- progression to permanent AF
- .70 (95% CI .54-.89)
Further pooled results
| Outcome | OR (95% CI) | |
|---|---|---|
| Antiarrhythmic drugs | 1.64 (1.33–2.03) | |
| Ablation therapy | 1.47 (1.06–2.05) | |
| 0.512Odds ratio (log scale) |
| Outcome | HR (95% CrI) |
|---|---|
| New-onset HF (Bayesian analysis) · CrI; Bayes factor = 1.2; not significant · Bayesian analysis otherwise comparable | 1.27 (.76-1.93) |
Original publication
Major clinical outcomes in symptomatic vs. asymptomatic atrial fibrillation: a meta-analysis. Eur Heart J. Published 21 October 2024. doi:10.1093/eurheartj/ehae694
Summarised from the published abstract; every number is checked against it