Arrhythmias and conduction disturbancePrevalence, Functional Impact, and Mortality of Atrial Fibrillation in an Older Italian Population (from the Pro.V.A. Study)
Section snippets
Methods
The Pro.V.A. study is an observational cohort study of an Italian population ≥65 years of age living in the community in 2 separate geographic areas of northeastern Italy. Study design, sample characteristics, and protocol have been published.1, 2 Briefly, the study population was sampled from all subjects ≥65 years old living in Camposampiero and Rovigo, 2 small cities surrounded by rural and industrial areas. No exclusion criteria were used. In the 2 areas, the proportion of inhabitants >65
Results
Demographic and baseline characteristics by gender are presented in Table 1. Mean ages were 77 ± 8 in men and 76 ± 7 in women.
ECGs were obtained from all 1,599 subjects at baseline and at follow-up (mean time 4 years). Of these, 23 were not readable because of technical reasons; the final analysis, therefore, was performed in 1,576 subjects. Overall, the weighted prevalence of AF was 7.4% and increased with advancing age (Table 2). At follow-up, 65 new cases of AF were registered, corresponding
Discussion
AF is the most prevalent arrhythmia affecting the general population, with a higher prevalence in older patients, and is a major determinant of quality of life and disability and a considerable source of morbidity and mortality.4
Most previous studies exploring AF and its impact on morbidity/mortality in older subjects have been performed in the United States or northern Europe. Very few studies have been done in a prospective population-based setting, whereas others have focused on hospitalized
Acknowledgment
This study was designed in collaboration with the University of Padua and local health units 15 and 18 of the Veneto Region. We are thankful to all personnel who collaborated in the data collection and analysis and to all participants.
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Factors associated with poor prognosis in patients with atrial fibrillation: An emergency department perspective the EMERG-AF study
2021, American Journal of Emergency MedicineCitation Excerpt :Disability was the factor that showed the strongest association with a poor prognosis both in the short and the long term, and this association remained significant in all sensitivity analyses, and with greater relevance than age. These results strengthen the idea already suggested by other authors that disability, frailty and functional status are more relevant than age in terms of prognosis [25-27]. Indeed, our results confirm that it is not age but a patient's risk profile that should be the deciding factor when prescribing stroke prophylaxis in elderly patients, after a comprehensive evaluation that includes disability, frailty, cardiovascular risk, and functional status [28].
Effect of atrial fibrillation on response to exercise-based cardiac rehabilitation in older individuals with heart failure
2021, Annals of Physical and Rehabilitation MedicineCognitive impairment in patients with atrial fibrillation: Implications for outcome in a cohort study
2021, International Journal of CardiologyCitation Excerpt :In that study heart failure, sex and age, but not AF, were associated with CImp [24]. Also in another study from Italy, with a slightly older patient population [25], the prevalence of CImp, as evaluated by MMSE, was higher than in our cohort suggesting that many factors related to clinical status and clinical history, but also to social status and education may contribute to the prevalence of CImp and dementia [2,26,27]. In a more general view it is clear that the different tests used for qualifying patients as affected by CImp and dementia and the variable settings and patient characteristics included in the different studies reported in literature suggest the need for more focused, standardized and validated approaches to this topical epidemiological issue [28].
Atrial Fibrillation and Cognitive Impairment: New Insights and Future Directions
2020, Heart Lung and CirculationDementia and Atrial Fibrillation: Pathophysiological Mechanisms and Therapeutic Implications
2018, American Journal of MedicineCitation Excerpt :A history of stroke in subjects with atrial fibrillation could not account for these associations. Since then, several cross-sectional and longitudinal studies investigating this association irrespective of stroke have yielded conflicting results3-18,26-33 (Table). However, most prospective studies and three meta-analyses24,25,34 have endorsed a relationship between atrial fibrillation and dementia.
Mechanisms, Clinical Significance, and Prevention of Cognitive Impairment in Patients With Atrial Fibrillation
2017, Canadian Journal of Cardiology
This work was funded by Fondazione Cassa di Risparmio di Padova e Rovigo, Padua, Italy.