prognosis
Last edited 04/2021 and last reviewed 07/2022
- relative risk of stroke in rheumatic heart disease with atrial fibrillation was 17.6 times higher than in normal controls
- atrial fibrillation associated with non-rheumatic heart disease was associated with a 5.6 times increase in risk of stroke relative to normal controls
- the risk of stroke for lone atrial
fibrillation was 4 times normal controls
- comorbidities significantly modulate progression and complications of atrial fibrillation. Age or development of hypertension increases thromboembolic risk (2)
- risk of embolization in paroxysmal atrial fibrillation is uncertain
- female sex in patients with AF without rheumatic heart disease is associated with a higher risk of stroke
- underlying heart disease increases the risk of stroke in non-rheumatic atrial fibrillation
- up to 20% of patients with atrial fibrillation and a stroke will have a second stroke within one year
- a third of patients with paroxysmal atrial fibrillation develop chronic atrial fibrillation over two to three years
-
in a follow-up of the Framingham study, atrial fibrillation was independently
associated with a 50-90% increase in the risk of death
- Ponamgi et al have stated that atrial fibrillation is associated with a nearly twofold excess risk of all cause mortality (3)
Reference:
- (1) Benjamin ET et al 1998. Impact of atrial fibrillation on the risk of death. The Framingham Heart Study. Circulation 1998; 98:946-52.
- (2) Jahangir A et al. Long-term progression and outcomes with aging in patients with lone atrial fibrillation: a 30-year follow-up study.Circulation. 2007 Jun 19;115(24):3050-6
- (3) Ponamgi SP et al. Screening and management of atrial fibrillation in primary care. BMJ 2021;372:mn379 http://dx.doi.org/10.1136/bmj.mn379