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Sinus Node Dysfunction Is Associated With Higher Symptom Burden and Increased Comorbid Illness: Results From the ORBIT-AF Registry.

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Date
2016-02
Authors
Jackson, Larry R
Kim, Sung Hee
Piccini, Jonathan P
Gersh, Bernard J
Naccarelli, Gerald V
Reiffel, James A
Freeman, James
Thomas, Laine
Chang, Paul
Fonarow, Gregg C
Go, Alan S
Mahaffey, Kenneth W
Peterson, Eric D
Kowey, Peter R
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(14 total)
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Abstract
BACKGROUND: Patients with sinus node dysfunction (SND) have increased risk of atrial tachyarrhythmias, including atrial fibrillation (AF). To date, treatment patterns and outcomes of patients with SND and AF have not been well described. HYPOTHESIS: Patients with SND and AF have higher risk of adverse cardiovascular outcomes. METHODS: Sinus node dysfunction was defined clinically, based on treating physician. Treatment patterns were described and logistic regression analysis performed to assess outcomes. RESULTS: Overall, 1710 (17.7%) out of 9631 patients had SND at enrollment. Patients with SND and AF had increased comorbid medical illnesses, more severe symptoms (European Heart Rhythm Association class IV: 17.5% vs 13.9%; P = 0.0007), and poorer quality of life (median 12-month Atrial Fibrillation Effect on Quality of Life score: 79.6 vs 85.2; P = 0.0008). There were no differences in AF management strategy between patients with SND and those without (rate control, 69.7% vs 67.7%; rhythm control, 30.0% vs 32.0%; P = 0.11). After adjustment, patients with SND were more likely than those without SND to progress from paroxysmal AF at baseline to persistent or permanent AF at any follow-up, or persistent AF at baseline to permanent AF at any follow-up (odds ratio: 1.23, 95% confidence interval: 1.01-1.49, P = 0.035). However, there was no association between SND and major risk-adjusted outcomes. CONCLUSIONS: Sinus node dysfunction is present in 1 of 6 patients with AF and is associated with increased comorbidities and higher symptom burden. However, SND is not associated with an increase in major risk-adjusted outcomes.
Type
Journal article
Subject
Aged
Aged, 80 and over
Atrial Fibrillation
Chi-Square Distribution
Comorbidity
Disease Progression
Female
Humans
Logistic Models
Male
Odds Ratio
Proportional Hazards Models
Prospective Studies
Quality of Life
Registries
Risk Assessment
Risk Factors
Severity of Illness Index
Sick Sinus Syndrome
Time Factors
Treatment Outcome
United States
Permalink
https://hdl.handle.net/10161/14993
Published Version (Please cite this version)
10.1002/clc.22504
Publication Info
Jackson, Larry R; Kim, Sung Hee; Piccini, Jonathan P; Gersh, Bernard J; Naccarelli, Gerald V; Reiffel, James A; ... Kowey, Peter R (2016). Sinus Node Dysfunction Is Associated With Higher Symptom Burden and Increased Comorbid Illness: Results From the ORBIT-AF Registry. Clin Cardiol, 39(2). pp. 119-125. 10.1002/clc.22504. Retrieved from https://hdl.handle.net/10161/14993.
This is constructed from limited available data and may be imprecise. To cite this article, please review & use the official citation provided by the journal.
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Scholars@Duke

Jackson

Larry Ronald Jackson II

Assistant Professor of Medicine
Peterson

Eric David Peterson

Fred Cobb, M.D. Distinguished Professor of Medicine
Dr Peterson is the Fred Cobb Distinguished Professor of Medicine in the Division of Cardiology, a DukeMed Scholar, and the Past Executive Director of the Duke Clinical Research Institute (DCRI), Durham, NC, USA. Dr Peterson is the Principal Investigator of the National Institute of Health, Lung and Blood Institute (NHLBI) Spironolactone Initiation Registry Randomized Interventional Trial in Heart Failure With Preserved Ejection Fraction (SPIRRIT) Trial  He is also the Principal I
This author no longer has a Scholars@Duke profile, so the information shown here reflects their Duke status at the time this item was deposited.
Piccini

Jonathan Paul Piccini Sr.

Associate Professor of Medicine
Jonathan P. Piccini, MD, MHS, FACC, FAHA, FHRS is a clinical cardiac electrophysiologist and Associate Professor of Medicine with Tenure at Duke University Medical Center and the Duke Clinical Research Institute. He is the Director of the Cardiac Electrophysiology section at the Duke Heart Center. His focus is on the care of patients with atrial fibrillation and complex arrhythmias, with particular emphasis on catheter ablation, left atrial appendage occlusion, and lead extraction. His resear
Thomas

Laine Elliott Thomas

Associate Professor of Biostatistics & Bioinformatics
Causal Inference, Heterogeneity of Treatment Effects, Observational Data, Time-varying Treatments, Real World Evidence
Alphabetical list of authors with Scholars@Duke profiles.
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