CHADS2 score predicts time interval free of atrial fibrillation in patients with symptomatic paroxysmal atrial fibrillation.

摘要

Long-term risk of stroke in valvular atrial fibrillation (AF) depends on clinical predictors, which are collectively assessed in the CHADS2 scoring scheme, an acronym for Congestive heart failure, Hypertension, Age>75, Diabetes mellitus, and prior Stroke [2]. In contrast, immediate risk of stroke in patients with AF undergoing cardioversion solely depends on duration of AF episode [3]. AF duration of less than 48 h carries insignificant risk of stroke during cardioversion [4], while as many as 12% of patients with AF duration greater than 48 h will have a dot formed in the left atrium and a significant risk of stroke [5]. Surprisingly, risk of stroke in paroxysmal atrial fibrillation (PAF) and chronic/permanent AF appears similar [1]. None of the studies so far have provided an answer as to what amount and/or duration of PAF episodes increases the risk of stroke. The purpose of our study is to evaluate stroke incidence in patients with symptomatic PAF during the time interval free of any episodes of AF (AF-free interval); and determine possible relationship between AF-free interval and various clinical characteristics including CHADS2 score, ejection fraction (EF), gender and use of antiarrhythmics.