Arrhythmias & electrophysiologyDiagnostic or prognostic study
Risk factors and clinical outcomes in patients with newly diagnosed asymptomatic atrial fibrillation
- VITAL Rhythm study
- time-updated multivariable Cox competing-risk models
- time-dependent indicators for atrial fibrillation (AF) type and interim CVD events
Authors' conclusion
Men and individuals with higher body mass index and systolic blood pressure are more likely to have asymptomatic AF. Mortality risk in these patients is largely driven by potentially preventable CVD events, emphasizing the importance of targeted screening and early cardiovascular risk management to improve outcomes.
Study context
- Population
- Participants free of baseline cardiovascular disease [CVD] and AF
- Participants
- 25,114 participants
- Comparison
- asymptomatic vs symptomatic AF
Performance
As reported in the abstract
New-onset AF · median of 7.3 years
developed new-onset AF
5.0%
of those with new-onset AF, asymptomatic
29.3%
Further findings
| Outcome | asymptomatic AF | symptomatic AF |
|---|---|---|
| Mortality after adjusting for interim nonfatal CVD | ||
| hazard ratio | 0.98 (95% confidence interval 0.67-1.45) | 1.54 (95% confidence interval 1.19-1.98) |
- Mortality after adjusting for interim nonfatal CVD: P differential = .046
Risk factors for asymptomatic vs symptomatic AF
- Male sex, body mass index, and elevated systolic blood pressure more strongly associated with asymptomatic than symptomatic AF
- P differential < .04 for all
Stroke, myocardial infarction, and death after AF onset
- Both groups had similarly increased risks
Heart failure
- risk of heart failure was higher for symptomatic AF
- P differential = .03
Original publication
Risk factors and clinical outcomes in patients with newly diagnosed asymptomatic atrial fibrillation. Heart Rhythm. Published 25 February 2026. doi:10.1016/j.hrthm.2026.01.056
Summarised from the published abstract; every number is checked against it