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

dc.contributor.author

Jackson, Larry R

dc.contributor.author

Kim, Sung Hee

dc.contributor.author

Piccini, Jonathan P

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Gersh, Bernard J

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Naccarelli, Gerald V

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Reiffel, James A

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Freeman, James

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Thomas, Laine

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Chang, Paul

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Fonarow, Gregg C

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Go, Alan S

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Mahaffey, Kenneth W

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Peterson, Eric D

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Kowey, Peter R

dc.coverage.spatial

United States

dc.date.accessioned

2017-07-06T13:27:06Z

dc.date.available

2017-07-06T13:27:06Z

dc.date.issued

2016-02

dc.description.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.

dc.identifier

https://www.ncbi.nlm.nih.gov/pubmed/26720750

dc.identifier.eissn

1932-8737

dc.identifier.uri

https://hdl.handle.net/10161/14993

dc.language

eng

dc.publisher

Wiley

dc.relation.ispartof

Clin Cardiol

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10.1002/clc.22504

dc.subject

Aged

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Aged, 80 and over

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Atrial Fibrillation

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Chi-Square Distribution

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Comorbidity

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Disease Progression

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Female

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Humans

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Logistic Models

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Male

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Odds Ratio

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Proportional Hazards Models

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Prospective Studies

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Quality of Life

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Registries

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Risk Assessment

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Risk Factors

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Severity of Illness Index

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Sick Sinus Syndrome

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Time Factors

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Treatment Outcome

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United States

dc.title

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

dc.type

Journal article

duke.contributor.orcid

Jackson, Larry R|0000-0002-0195-1081

duke.contributor.orcid

Piccini, Jonathan P|0000-0003-0772-2404

duke.contributor.orcid

Peterson, Eric D|0000-0002-5415-4721

pubs.author-url

https://www.ncbi.nlm.nih.gov/pubmed/26720750

pubs.begin-page

119

pubs.end-page

125

pubs.issue

2

pubs.organisational-group

Basic Science Departments

pubs.organisational-group

Biostatistics & Bioinformatics

pubs.organisational-group

Clinical Science Departments

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Duke

pubs.organisational-group

Duke Clinical Research Institute

pubs.organisational-group

Institutes and Centers

pubs.organisational-group

Medicine

pubs.organisational-group

Medicine, Cardiology

pubs.organisational-group

School of Medicine

pubs.publication-status

Published

pubs.volume

39

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