Clinical Electrophysiology -> Atrial Fibrillation & Atrial Flutter: -> Physiology D-AB27 - Arrhythmias, infiltration and hypertrophy (ID 27) Abstract

D-AB27-01 - Atrial Fibrillation Burden In Patients With Cardiac Amyloidosis (ID 806)


Background: Cardiac amyloidosis (CA) is an infiltrative disease of the myocardium commonly associated with arrhythmias such as atrial fibrillation (AF). Limited data exist regarding the impact of AF burden on outcomes in this population.
Objective: Quantify AF burden and determine its relationship to New York Heart Association (NYHA) functional class and survival in patients with CA.
Methods: Patients with CA and a cardiac implantable electronic device were identified within the Duke University Health System. Baseline characteristics including age, LVEF, history of AF, and NYHA class at implant were recorded. Longitudinal AF burden was abstracted from interrogation reports and its relationship to NYHA class and subsequent mortality was assessed.
Results: Among 34 CA patients, 23 patients had a diagnosis of AF. AF burden was higher in patients with NYHA class III/IV (9.3±2.2 hours/day) as compared to patients with NYHA class I/II heart failure (0.8±0.5 hours/day) (Figure A). Patients with less than 4 hours of AF per day had a 3-year mortality rate of 19% compared to 46% in patients with AF burden greater than 4 hours per day (Figure B).
Conclusion: Higher AF burden is associated with worse NYHA functional class and lower overall survival in CA. Further studies are needed to determine if reducing AF burden can alter the natural progression of the disease.