Cardiac rhythm and systemic embolism in long-term follow up of patients with non-valvular paroxysmal atrial fibrillation
Bugueño, C.; Corbalán, R.; Braun, S.; Tapia, J.; Kramer, A.; Huete, I.; Chávez, A.
Revista Medica de Chile 126(6): 646-654
1998
ISSN/ISBN: 0034-9887 PMID: 9778872 Document Number: 485438
Paroxysmal atrial fibrillation may predispose to systemic embolism. There is little information about the evolution of cardiac rhythm and the occurrence of new embolic events in these patients. To report the results of a long term follow up of patients with paroxysmal atrial fibrillation. Patients consulting for non valvular paroxysmal atrial fibrillation were followed for a mean period of 5 years. An EKG, 2D echocardiogram and brain CT scans were performed on admission and at the end of the follow up period to all patients. Sixty eight patients aged 65 +/- 1.5 years were studied. Thirty two had an idiopathic atrial fibrillation, 28 had a history of mild hypertension and 8 had a history of coronary artery disease. Evidence of systemic emboli was found in 17 patients at entry (to the brain in 14 patients). During the follow up 87% of patients required antiarrhythmics, 27% were anticoagulated and 28% received aspirin. Five patients had new embolic episodes. Of these, four had a history of prior embolism. Forty one percent of patients continued in sinus rhythm and remained asymptomatic, 32% had at least one recurrence of paroxysmal atrial fibrillation and nine patients evolved to chronic atrial fibrillation. Five patients required a permanent pacemaker due to symptomatic bradycardia. Most patients with non valvular paroxysmal atrial fibrillation remain in sinus rhythm but one third have recurrences of the arrhythmia. A main risk factor for embolism is the history of previous embolic episodes.