Clinical Profiles, Efficacy of Antiarrhythmic Drug Therapy, and Cardiovascular Prognosis in Patients With First Detected Paroxysmal Atrial Fibrillation
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概要
- 論文の詳細を見る
Little information is available concerning clinical profiles and outcomes of treatment in Japanese patients with first detected atrial fibrillation (AF). In the present study, 459 patients with paroxysmal AF (309 males, mean age, 66 ± 12 years) were divided into a first detected AF group (group A, n = 143) and a non-first detected AF group (group B, n = 316). Clinical profiles, prophylactic efficacy of antiarrhythmic drug therapy (AAD), and cardiovascular prognosis during a mean follow-up period of 50 ± 35 months were compared between the two groups. The number of AF recurrences in the individual patients regardless of AAD were significantly lower in group A than in group B (0.8 ± 1.4 versus 1.7 ± 1.9)(P < 0.05). The percentages of patients free from conversion to chronic AF at 12, 36, 60, and 120 months were significantly higher in group A (98%, 96%, 93%, and 91%, respectively) than in group B (95%, 86%, 83%, and 79%, respectively)(P < 0.01). The annual rates of hospitalization for thromboembolism, heart failure, and cardiovascular death did not differ between group A (2.2%, 1.1% and 1.0%, respectively) and group B (2.2%, 1.9% and 1.1%, respectively). In multivariate logistic regression analysis, a CHADS2 score ≥ 2 points (odds ratio 13.1, 95% confidence interval 3.36-51.0, P = 0.001), nocturnal AF onset (OR 0.201, 95% CI 0.050-0.815, P = 0.025), left ventricular diastolic dimension (LVDd) ≥ 50 mm (OR 3.845, 95% CI 1.078-13.71, P = 0.038), and conversion to chronic AF (OR 3.547, 95% CI 1.002-13.64, P = 0.048) were associated with cardiovascular events in group A. Rhythm control therapy with antiarrhythmic drugs was shown to be more effective for patients in group A than in group B. It is particularly important to prevent cardiovascular events in first detected AF patients with a CHADS2 score ≥ 2 points, LVDd ≥ 50 mm, and conversion to chronic AF.
著者
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Tachibana Hideaki
Division of Cardiology, Department of Internal Medicine, Iwate Medical University School of Medicine
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Tachibana Hideaki
Division Of Cardiology Department Of Internal Medicine And Memorial Heart Center Iwate Medical Unive
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Komatsu Takashi
Division Of Cardiology Department Of Internal Medicine And Memorial Heart Center Iwate Medical Unive
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Nakamura Motoyuki
Division Of Cardiology Department Of Internal Medicine And Memorial Heart Center Iwate Medical Unive
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Satoh Yoshihiro
Division Of Cardiology Department Of Medicine Nihon University School Of Medicine
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Ozawa Mahito
Division of Cardiology, Department of Internal Medicine, Iwate Medical University School of Medicine
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Ozawa Mahito
Division of Cardio-angiology, Nephrology and Endocrinology, Department of Internal Medicine, Iwate Medical University
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Satoh Yoshihiro
Division of Cardiology, Department of Internal Medicine, Iwate Medical University School of Medicine
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Kunugita Fusanori
Division of Cardiology, Department of Internal Medicine, Iwate Medical University School of Medicine
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Kunugita Fusanori
Division of Cardio-angiology, Nephrology and Endocrinology, Department of Internal Medicine, Iwate Medical University
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