6/30/2023 0 Comments Atrial fibrillation ivcd![]() RBBB and LBBB were identified by standard criteria. Rhythm and conduction abnormalities were characterized in the admission ECG. The ECGs in each cohort were analysed by two to three researchers (medical doctors) specially trained for and assigned to the task. Final AHF diagnosis was confirmed by the local investigators based on all clinical, laboratory, and imaging information. The end point of interest was all‐cause mortality. These together resulted in a cohort of 982 AHF patients with a mean follow‐up period of 3.9 years (95% CI 3.7–4.0 years) the median follow‐up time was 5 years. 9 For the present analysis, only patients with an adjudicated diagnosis of AHF ( n = 387) were included, in all of which the admission ECG was available. ![]() The BASEL V study (B‐type Natriuretic Peptide for Acute Shortness of Breath EvaLuation 2006–2007) recruited patients presenting to the emergency department with a chief complaint of shortness of breath. The admission ECG was available for 595 (96%) patients. 8 Vital status at 5 years after the index hospitalization and time of death were obtained from the National Population Registry. The FINN‐AKVA (Finnish Acute Heart Failure Study) study is a prospective, national multicentre study, which enrolled 620 consecutive patients with AHF in 2004 in Finland. In this study, we aimed to examine the characteristics in the admission electrocardiogram (ECG) in a large multicentre European cohort of patients hospitalized for AHF and to assess the differences in their impact on long‐term prognosis in patients with de novo AHF and ADCHF.ĭata from two independent prospectively collected cohorts were combined for this analysis. 7 Whether differences exist in the prevalence of ventricular conduction abnormalities and their effect on long‐term mortality in a comparison between patients with de novo AHF and ADCHF remains unknown. Patients with new‐onset ( de novo) AHF differ significantly in their medical history, clinical presentation, and long‐term survival from those with acutely decompensated chronic heart failure (ADCHF). This may in part be due to differences in the baseline characteristics of the patient cohorts and in the length of follow‐up period. Only few studies have investigated the prognostic impact of specific types of ventricular conduction abnormalities, that is, right bundle branch block (RBBB) or left bundle branch block (LBBB), in the long‐term survival of AHF, and the findings have been controversial. 1, 2 However, the role of ventricular conduction abnormalities in the pathophysiology and prognosis of AHF is not well established. Prolonged QRS duration with or without bundle branch block (BBB) is both frequent and has been associated with increased mortality and morbidity in several studies in chronic heart failure. The main results were confirmed in a validation cohort of 1511 AHF patients with 5.9 years' mean follow‐up.Īcute heart failure (AHF) is the leading cause of hospitalization for patients aged over 65 years in the Western world, and long‐term survival with AHF is dismal. LBBB showed no association with increased mortality in either of the subgroups. Both findings were pronounced in patients with reduced ejection fraction. The impact of RBBB on prognosis was prominent in de novo AHF (adjusted HR 1.93, 1.03–3.60 P = 0.04), and IVCD independently predicted death in ADCHF (adjusted HR 1.79, 1.28–2.52 P = 0.001). Mortality during the follow‐up was higher in patients with RBBB (85.4%) and IVCD (73.7%) compared with patients with normal ventricular conduction (57.0%) P < 0.001 for both. LBBB, and IVCD were more common in ADCHF than in de novo AHF: 17.2% vs. ![]() Half (51.5%, n = 506) of the patients had de novo AHF. We analysed the admission electrocardiogram of 982 patients from a multicenter European cohort of AHF with 3.9 years' mean follow‐up. ![]()
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