N.S. Pavlyk, U.P. Chernyaha-Royko, S.S. Pavlyk, O.J. Zharinov. Clinical characteristics of hospitalized patients with silent atrial fibrillation and flutter in one-center registry.

The aim – to study the prevalence of silent atrial fibrillation (AF) and atrial flutter (AFL) in hospitalized patients, to compare cardiovascular risk, clinical characteristics, myocardial structure and function in patients with and without symptoms of arrhythmia.

Material and methods. The study included 685 patients with different forms of AF/AFL, consecutively hospitalized into the regional cardiology centre from January to June 2013. All patients were divided into two groups depending on arrhythmia symptoms evaluated according to the EHRA classification. The first group consisted of 105 (15.3 %) patients with asymptomatic AF/AFL, second group – 580 (84.7 %) patients with symptomatic arrhythmia. Cardiovascular risk factors (CHA2DS2-VASc), clinical characteristics and echocardiographic parameters were compared between two groups.

Results. There were no significant differences between two groups regarding age, gender, anthropometric parameters and harmful habits. There were also no statistically significant differences regarding earlier stroke, hypertension, diabetes mellitus, thromboembolic events, thyroid pathology, rheumatism, cardiomyopathies, valvular diseases and CHA2DS2-VASc cardiovascular risk factors between two groups. Asymptomatic patients with AF/AFL more often had heart failure ІІІ–ІV classes NYHA (40 (38.1 %) against 123 (21.2 %), Р=0.001). They had larger left atrium (4.6 (4.1–5.1) against 4.5 (4.0–4.9) cm, Р=0.05) and left ventricle (5.5 (4.9–5.9) against 5.2 (4.8–5.8) cm, Р=0.04).

Conclusions. Arrhythmia is asymptomatic in 15.3 % hospitalized patients with AF/AFL. Patients with silent AF/AFL had more prevalence of heart failure ІІІ–IV classes NYHA, larger left atrium and left ventricle. Independent of arrhythmia symptoms, the investigated cohort had high risk of thromboembolic complications.

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