FEATURES OF THE CLINICAL COURSE OF ATRIAL FIBRILLATION IN PATIENTS WITH HEART FAILURE WITH MILDLY REDUCED LEFT VENTRICULAR EJECTION FRACTION
DOI:
https://doi.org/10.11603/1811-2471.2025.v.i4.15770Keywords:
atrial fibrillation, heart failure, left ventricular ejection fractionAbstract
SUMMARY. The aim – to determine the impact of heart failure with mildly reduced ejection fraction (HFwmrEF) compared with preserved left ventricular ejection fraction on the clinical course of atrial fibrillation.
Material and Methods. The study analyzed the inpatient medical records of 335 patients with atrial fibrillation and heart failure. The cohort included 186 (55.5 %) men and 149 (44.5 %) women aged 38 to 87 years; the mean age was (67.07±10.76) years. All patients were divided into two groups: patients with atrial fibrillation (AF) and heart failure with mildly reduced ejection fraction (HFwmrEF): 116 (34.6 %), and patients with AF and heart failure with preserved ejection fraction (HFwpEF): 219 (65.4 %).
Results. In patients with mildly reduced ejection fraction (HFwmrEF), a significant shift in the distribution of atrial fibrillation patterns was observed compared with the group with preserved EF (HFwpEF). The proportion of permanent AF in the HFwmrEF group was substantially higher – 55.2 % vs. 31.5 % in HFwpEF. In contrast, persistent AF was registered more frequently in patients with preserved EF – 54.8 % compared with 37.9 %. Paroxysmal AF was uncommon in both groups; however, its frequency was lower in HFwmrEF – 6.9 % versus 13.7 % (OR 2.67, 95 % CI: 1.68–4.25, p<0.001). Thus, mildly reduced EF significantly affects the progression of atrial fibrillation, promoting its transition to the permanent form.
Conclusions. Reduced ejection fraction is associated with increased odds and risk of developing permanent AF (OR=2.67, RR=1.75, p<0.001).
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