Clinical characteristics of patients with asymptomatic recurrences of atrial fibrillation in the Gruppo Italiano per lo Studio della Sopravvivenza nell'Infarto Miocardico-Atrial Fibrillation (GISSI-AF) trial

Marcello Disertori, Federico Lombardi, Simona Barlera, Aldo Pietro Maggioni, Chiara Favero, Maria Grazia Franzosi, Donata Lucci, Lidia Staszewsky, Gianna Fabbri, Silvia Quintarelli, Leopoldo Bianconi, Roberto Latini

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

Background: Atrial fibrillation (AF) is a common arrhythmia that frequently recurs after restoration of sinus rhythm. In a consistent percentage of cases, AF recurrences are asymptomatic, thus making its clinical management difficult in relation to both therapeutic efficacy and thromboembolic risk. Methods: The GISSI-AF trial enrolled 1,442 patients in sinus rhythm with previous AF episodes. Patients were randomized to valsartan or placebo and followed for 12 months. To improve the likelihood of detecting arrhythmic recurrences, arrhythmic follow-up was based on both programmed or symptom-related control visits and transtelephonic electrocardiographic transmissions. The present post hoc analysis was performed on 1,638 arrhythmic episodes that occurred in 623 patients. Results: Asymptomatic AF recurrences were present in 49.5% of patients. In multivariable analysis, asymptomatic AF recurrences were significantly associated with a longer duration of qualifying arrhythmias (odds ratio [95% CI] 1.57 (1.26-1.97), P 2 (Congestive heart failure, history of Hypertension, Age≥75 years, Diabetes mellitus, and past history of Stroke or TIA doubled) score and a more frequent use of amiodarone, calcium-channel blockers, and digitalis characterized patients with asymptomatic, whereas 1C drugs were more often used in subjects with symptomatic recurrences. Conclusion: Asymptomatic AF recurrences were frequent in the GISSI-AF study population in patients who were more likely to develop persistent-permanent AF and were characterized by an increased thromboembolic risk.

Original languageEnglish
Pages (from-to)382-389
Number of pages8
JournalAmerican Heart Journal
Volume162
Issue number2
DOIs
Publication statusPublished - Aug 2011

Fingerprint

Atrial Fibrillation
Recurrence
Valsartan
Cardiac Arrhythmias
Amiodarone
Digitalis
Calcium Channel Blockers
Diabetes Mellitus
Heart Failure
Stroke
Odds Ratio
Placebos
Hypertension
Pharmaceutical Preparations
Population

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Clinical characteristics of patients with asymptomatic recurrences of atrial fibrillation in the Gruppo Italiano per lo Studio della Sopravvivenza nell'Infarto Miocardico-Atrial Fibrillation (GISSI-AF) trial. / Disertori, Marcello; Lombardi, Federico; Barlera, Simona; Maggioni, Aldo Pietro; Favero, Chiara; Franzosi, Maria Grazia; Lucci, Donata; Staszewsky, Lidia; Fabbri, Gianna; Quintarelli, Silvia; Bianconi, Leopoldo; Latini, Roberto.

In: American Heart Journal, Vol. 162, No. 2, 08.2011, p. 382-389.

Research output: Contribution to journalArticle

Disertori, Marcello ; Lombardi, Federico ; Barlera, Simona ; Maggioni, Aldo Pietro ; Favero, Chiara ; Franzosi, Maria Grazia ; Lucci, Donata ; Staszewsky, Lidia ; Fabbri, Gianna ; Quintarelli, Silvia ; Bianconi, Leopoldo ; Latini, Roberto. / Clinical characteristics of patients with asymptomatic recurrences of atrial fibrillation in the Gruppo Italiano per lo Studio della Sopravvivenza nell'Infarto Miocardico-Atrial Fibrillation (GISSI-AF) trial. In: American Heart Journal. 2011 ; Vol. 162, No. 2. pp. 382-389.
@article{5d5857b47b6f40458187414cc183ceb4,
title = "Clinical characteristics of patients with asymptomatic recurrences of atrial fibrillation in the Gruppo Italiano per lo Studio della Sopravvivenza nell'Infarto Miocardico-Atrial Fibrillation (GISSI-AF) trial",
abstract = "Background: Atrial fibrillation (AF) is a common arrhythmia that frequently recurs after restoration of sinus rhythm. In a consistent percentage of cases, AF recurrences are asymptomatic, thus making its clinical management difficult in relation to both therapeutic efficacy and thromboembolic risk. Methods: The GISSI-AF trial enrolled 1,442 patients in sinus rhythm with previous AF episodes. Patients were randomized to valsartan or placebo and followed for 12 months. To improve the likelihood of detecting arrhythmic recurrences, arrhythmic follow-up was based on both programmed or symptom-related control visits and transtelephonic electrocardiographic transmissions. The present post hoc analysis was performed on 1,638 arrhythmic episodes that occurred in 623 patients. Results: Asymptomatic AF recurrences were present in 49.5{\%} of patients. In multivariable analysis, asymptomatic AF recurrences were significantly associated with a longer duration of qualifying arrhythmias (odds ratio [95{\%} CI] 1.57 (1.26-1.97), P 2 (Congestive heart failure, history of Hypertension, Age≥75 years, Diabetes mellitus, and past history of Stroke or TIA doubled) score and a more frequent use of amiodarone, calcium-channel blockers, and digitalis characterized patients with asymptomatic, whereas 1C drugs were more often used in subjects with symptomatic recurrences. Conclusion: Asymptomatic AF recurrences were frequent in the GISSI-AF study population in patients who were more likely to develop persistent-permanent AF and were characterized by an increased thromboembolic risk.",
author = "Marcello Disertori and Federico Lombardi and Simona Barlera and Maggioni, {Aldo Pietro} and Chiara Favero and Franzosi, {Maria Grazia} and Donata Lucci and Lidia Staszewsky and Gianna Fabbri and Silvia Quintarelli and Leopoldo Bianconi and Roberto Latini",
year = "2011",
month = "8",
doi = "10.1016/j.ahj.2011.05.008",
language = "English",
volume = "162",
pages = "382--389",
journal = "American Heart Journal",
issn = "0002-8703",
publisher = "Mosby Inc.",
number = "2",

}

TY - JOUR

T1 - Clinical characteristics of patients with asymptomatic recurrences of atrial fibrillation in the Gruppo Italiano per lo Studio della Sopravvivenza nell'Infarto Miocardico-Atrial Fibrillation (GISSI-AF) trial

AU - Disertori, Marcello

AU - Lombardi, Federico

AU - Barlera, Simona

AU - Maggioni, Aldo Pietro

AU - Favero, Chiara

AU - Franzosi, Maria Grazia

AU - Lucci, Donata

AU - Staszewsky, Lidia

AU - Fabbri, Gianna

AU - Quintarelli, Silvia

AU - Bianconi, Leopoldo

AU - Latini, Roberto

PY - 2011/8

Y1 - 2011/8

N2 - Background: Atrial fibrillation (AF) is a common arrhythmia that frequently recurs after restoration of sinus rhythm. In a consistent percentage of cases, AF recurrences are asymptomatic, thus making its clinical management difficult in relation to both therapeutic efficacy and thromboembolic risk. Methods: The GISSI-AF trial enrolled 1,442 patients in sinus rhythm with previous AF episodes. Patients were randomized to valsartan or placebo and followed for 12 months. To improve the likelihood of detecting arrhythmic recurrences, arrhythmic follow-up was based on both programmed or symptom-related control visits and transtelephonic electrocardiographic transmissions. The present post hoc analysis was performed on 1,638 arrhythmic episodes that occurred in 623 patients. Results: Asymptomatic AF recurrences were present in 49.5% of patients. In multivariable analysis, asymptomatic AF recurrences were significantly associated with a longer duration of qualifying arrhythmias (odds ratio [95% CI] 1.57 (1.26-1.97), P 2 (Congestive heart failure, history of Hypertension, Age≥75 years, Diabetes mellitus, and past history of Stroke or TIA doubled) score and a more frequent use of amiodarone, calcium-channel blockers, and digitalis characterized patients with asymptomatic, whereas 1C drugs were more often used in subjects with symptomatic recurrences. Conclusion: Asymptomatic AF recurrences were frequent in the GISSI-AF study population in patients who were more likely to develop persistent-permanent AF and were characterized by an increased thromboembolic risk.

AB - Background: Atrial fibrillation (AF) is a common arrhythmia that frequently recurs after restoration of sinus rhythm. In a consistent percentage of cases, AF recurrences are asymptomatic, thus making its clinical management difficult in relation to both therapeutic efficacy and thromboembolic risk. Methods: The GISSI-AF trial enrolled 1,442 patients in sinus rhythm with previous AF episodes. Patients were randomized to valsartan or placebo and followed for 12 months. To improve the likelihood of detecting arrhythmic recurrences, arrhythmic follow-up was based on both programmed or symptom-related control visits and transtelephonic electrocardiographic transmissions. The present post hoc analysis was performed on 1,638 arrhythmic episodes that occurred in 623 patients. Results: Asymptomatic AF recurrences were present in 49.5% of patients. In multivariable analysis, asymptomatic AF recurrences were significantly associated with a longer duration of qualifying arrhythmias (odds ratio [95% CI] 1.57 (1.26-1.97), P 2 (Congestive heart failure, history of Hypertension, Age≥75 years, Diabetes mellitus, and past history of Stroke or TIA doubled) score and a more frequent use of amiodarone, calcium-channel blockers, and digitalis characterized patients with asymptomatic, whereas 1C drugs were more often used in subjects with symptomatic recurrences. Conclusion: Asymptomatic AF recurrences were frequent in the GISSI-AF study population in patients who were more likely to develop persistent-permanent AF and were characterized by an increased thromboembolic risk.

UR - http://www.scopus.com/inward/record.url?scp=80051667916&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=80051667916&partnerID=8YFLogxK

U2 - 10.1016/j.ahj.2011.05.008

DO - 10.1016/j.ahj.2011.05.008

M3 - Article

C2 - 21835301

AN - SCOPUS:80051667916

VL - 162

SP - 382

EP - 389

JO - American Heart Journal

JF - American Heart Journal

SN - 0002-8703

IS - 2

ER -