Skip Navigation

Europace 1999 1(4):226-233; doi:10.1053/eupc.1999.0059
© 1999 by European Society of Cardiology
This Article
Right arrow Abstract Freely available
Right arrow FREE Full Text (PDF) Freely available
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrow Search for citing articles in:
ISI Web of Science (6)
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Goudevenos, J.A.
Right arrow Articles by Sideris, D.A.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Goudevenos, J.A.
Right arrow Articles by Sideris, D.A.
Social Bookmarking
 Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

An epidemiological study of symptomatic paroxysmal atrial fibrillation in northwest Greece

J.A. Goudevenos, J.N. Vakalis, V. Giogiakas, P. Lathridou, C. Katsouras, L.K. Michalis and D.A. Sideris

Division of Cardiology, School of Medicine, University of Ioannina Ioannina, Greece

AIM: Although atrial fibrillation (AF) is the most commonly sustained arrhythmia, information about its incidence in the general population is sparse. Even more sparse is information on an important variety of AF, paroxysmal AF. The aim of this study is to assess the frequency of new cases of symptomatic paroxysmal AF per year (‘incidence’) in a general unselected population and to compare other epidemiological features with chronic AF patients.

METHODS AND RESULTS: Over a 4 year period, we conducted a prospective, population-based survey of cases of AF in a defined geographical area with a known population size stratified for age and sex. Sources of identification were the two hospitals which serve the area and all the primary care settings. Patients with AF of less than 7 days duration were characterized as paroxysmal AF and all others as chronic AF. During the study period we identified 1551 patients with chronic AF (51·7% male, mean age 71±10·4 years and 48·3% females, mean age 73·1±10·8 years) and 443 patients with paroxysmal AF (59·6% male, mean age 59·6±13·3 years and 40·4% female, mean age 65·2±10·1 years). There was no underlying cardiovascular disease in 15·6% and 32·3% of patients with chronic and paroxysmal AF, respectively. The mean annual occurrence of new cases of paroxysmal AF was 6·2/10 000/year, and was higher (P<0·01) for men (7·2/10 000/year) than for women (5·3/10 000/year). The frequency of new paroxysmal AF cases rises with age, reaching a peak at 70–79 years and then declines.

CONCLUSIONS: We conclude that paroxysmal AF is a relatively common arrhythmia, the occurrence of which increases with age and is more frequent in younger men than in women. Patients with chronic AF are older and more often have underlying heart and other disease than patients with paroxysmal AF.

Key Words: Paroxysmal atrial fibrillation, epidemiology


Correspondence: J. A. Goudevenos, MD, FESC, FACC, Associate Professor of Cardiology, School of Medicine, University of Ioannina, GR 451 10 Ioannina, Greece.


[1] Prystowsky EN, Benson DW, Fuster V. Management of patients with atrial fibrillation. A statement for healthcare professionals. From the subcommittee on electrocardiography and electrophysiology, American Heart Association. Circulation 1996; 93: 1262–1277.[Medline]

[2] Kannel WB, Abbott RD, Savage DD, McNamara PM. Epidemiologic features of chronic atrial fibrillation: The Framingham study. N Engl J Med 1982; 306: 1018–1022.[Abstract]

[3] Wolf PA, Abbott RD, Kannel WB. Atrial Fibrillation as an independent risk factor for stroke: the Framingham study. Stroke 1991; 22: 983–988.[Abstract/Free Full Text]

[4] Benjamin EJ, Levy D, Vaziri SM, D'Agostino RB, Belanger AJ, Wolf PA. Independent risk factors for atrial fibrillation in a population-based cohort. The Framingham Heart Study. JAMA 1994; 271: 840–844.[Abstract/Free Full Text]

[5] Kannel WB, Abbott RD, Savage DD. Coronary heart disease and atrial fibrillation: the Framingham study. Am Heart J 1983; 106: 389–396.[CrossRef][Web of Science][Medline]

[6] Gersh BJ. The epidemiology of atrial fibrillation and atrial flutter. In DiMarco JP and Prystowsky EN (Eds.). Atrial arrhythmias: the state of the art 1994; Armonk, NY Futura Publishing Co pp. 1–22.

[7] Aboaf AL and Wolf PS. Paroxysmal atrial fibrillation. A common but neglected entity. Arch Intern Med 1996; 146: 362–367.

[8] Pritchett ELC. Editorial comments. In DiMarco JP and Prystowsky EN (Eds.). Atrial arrhythmias: the state of the art 1994; Armonk, NY Futura Publishing Co pp. 23–29.

[9] Laupacis A, Albers G, Dunn M, Feinberg W. Antithrombotic therapy in atrial fibrillation. Chest 1992; 102: 426S–433S.

[10] Page RL, Wilkinson WE, Clair WK, McCarthy EA, Pritchett ELC. Asymptomatic arrhythmias in patients with symptomatic paroxysmal atrial fibrillation and paroxysmal supraventricular tachycardia. Circulation 1994; 89: 224–227.[Abstract/Free Full Text]

[11] Gallacher MM and Camm AJ. Classification of Atrial Fibrillation. PACE 1997; 20: 1603–1605.

[12] Pritchett ELC. The case for just plain ‘Atrial Fibrillation’. PACE 1998; 21: 637–640.

[13] Feinberg WM, Blackshear JL, Laupacis A, Kronmal R, Hart RG. Prevalence, age distribution, and gender of patients with atrial fibrillation. Arch Intern Med 1995; 155: 469–473.[Abstract/Free Full Text]

[14] Werkö L. Atrial fibrillation: introduction. In Olsson BS, Allessie MA, Campbell RWF (Eds.). Atrial Fibrillation. Mechanisms and Therapeutic Strategies 1994; Armonk, NY Futura Publishing Co pp. 1–14.

[15] Narayan SM, Cain ME, Smith JM. Atrial fibrillation. Lancet 1997; 350: 943–950.[CrossRef][Web of Science][Medline]

[16] Furberg CD, Psaty BM, Manolio TA, Gardin JM, Smith VE, Rautaharju PM. for the CHS Collaborative Research Group. Prevalence of atrial fibrillation in elderly subjects (the Cardiovascular Health Study). Am J Cardiol 1994; 74: 236–241.[CrossRef][Web of Science][Medline]

[17] Krahn AD, Manfreda J, Tate RB, Mathewson FAL, Cuddy TE. The natural history of atrial fibrillation: Incidence, risk factors and prognosis in the Manitoba Follow-up Study. Am J Med 1995; 98: 476–484.[CrossRef][Web of Science][Medline]

[18] Onundarson PT, Thorgeirsson G, Jonmundsson E, Sigfusson N, Hardarson Th. Chronic atrial fibrillation-epidemiologic features and 14 year follow-up: A case control Study. Eur Heart J 1987; 8: 521–527.[Abstract/Free Full Text]

[19] Takahashi N, Seki A, Imataka K, Fujii J. Clinical features of paroxysmal atrial fibrillation. Jpn Heart J 1981; 22: 143–149.[Medline]

[20] Suttorp MJ, Kingma JH, Koomen EM, Hof AV, Tijssen JGP, Lie KI. Recurrence of paroxysmal atrial fibrillation or flutter after successful cardioversion in patients with normal left ventricular function. Am J Cardiol 1993; 71: 710–713.[CrossRef][Web of Science][Medline]

[21] Clementy J, Dulhoste MN, Laiter C, Denjoy I, Dos Santos P. Flecainide acetate in the prevention of paroxysmal atrial fibrillation: a nine-month follow up of more than 500 patients. Am J Cardiol 1992; 70: 44A–49A.[CrossRef][Medline]

[22] Forfar JC and Toft AD. Thyrotoxic atrial fibrillation: an underdiagnosed condition. BMJ 1982; 285: 909–910.[Free Full Text]

[23] Presti CF and Hart RG. Thyrotoxicosis, atrial fibrillation and embolism, revisited. Am Heart J 1989; 117: 976–997.[CrossRef][Web of Science][Medline]

[24] Koskinen P and Kupari M. Alcohol and cardiac arrhythmias. Patients with unexplained tachyarrhythmias; should be questioned about their drinking. BMJ 1992; 304: 1394–1395.[Free Full Text]

[25] Murgatroyd FD and Camm AJ. Atrial arrhythmias. Lancet 1993; 341: 1317–1322.[CrossRef][Web of Science][Medline]

[26] Kopecky SL, Gersh BJ, McGoon MD. The natural history of lone atrial fibrillation: a population-based study over three decades. N Engl J Med 1987; 317: 669–674.[Abstract]

[27] Lip GYH and Beevers G. History, epidemiology and importance of atrial fibrillation. BMJ 1995; 311: 1361–1363.[Free Full Text]

[28] Brand FN, Abbott RD, Kannel WB. Characteristics and prognosis of lone atrial fibrillation: 30-year follow-up in the Framingham study. JAMA 1985; 254: 3449–3453.[Abstract/Free Full Text]


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?


This article has been cited by other articles:


Home page
Eur Heart JHome page
L. Friberg, N. Hammar, and M. Rosenqvist
Stroke in paroxysmal atrial fibrillation: report from the Stockholm Cohort of Atrial Fibrillation
Eur. Heart J., January 27, 2009; (2009) ehn599v1.
[Abstract] [Full Text] [PDF]


Home page
HeartHome page
P Korantzopoulos, T M Kolettis, A Papathanasiou, K K Naka, P Kolios, I Leontaridis, A Draganigos, C S Katsouras, and J A Goudevenos
Propafenone added to ibutilide increases conversion rates of persistent atrial fibrillation
Heart, May 1, 2006; 92(5): 631 - 634.
[Abstract] [Full Text] [PDF]


Home page
Eur Heart JHome page
R. Nieuwlaat, A. Capucci, A. J. Camm, S. B. Olsson, D. Andresen, D. W. Davies, S. Cobbe, G. Breithardt, J.-Y. Le Heuzey, M. H. Prins, et al.
Atrial fibrillation management: a prospective survey in ESC Member Countries: The Euro Heart Survey on Atrial Fibrillation
Eur. Heart J., November 2, 2005; 26(22): 2422 - 2434.
[Abstract] [Full Text] [PDF]


This Article
Right arrow Abstract Freely available
Right arrow FREE Full Text (PDF) Freely available
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrow Search for citing articles in:
ISI Web of Science (6)
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Goudevenos, J.A.
Right arrow Articles by Sideris, D.A.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Goudevenos, J.A.
Right arrow Articles by Sideris, D.A.
Social Bookmarking
 Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?