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BioMed Research International
Volume 2017, Article ID 5049802, 7 pages
https://doi.org/10.1155/2017/5049802
Research Article

Paroxysmal Atrial Fibrillation in the Course of Acute Pulmonary Embolism: Clinical Significance and Impact on Prognosis

1Department of Cardiology, Medical University of Białystok, Białystok, Poland
2Department of Cardiology, Procardia, Augustów, Poland
3Department of Statistics and Medical Informatics, Medical University of Białystok, Białystok, Poland
4Department of Anaesthesiology and Intensive Care, Medical University of Białystok, Białystok, Poland

Correspondence should be addressed to Bozena Sobkowicz; lp.pw@ciwokbos

Received 23 October 2016; Accepted 16 January 2017; Published 9 February 2017

Academic Editor: Xiao-Bo Liao

Copyright © 2017 Agnieszka Krajewska et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

The relationship and clinical implications of atrial fibrillation (AF) in acute pulmonary embolism (PE) are poorly investigated. We aimed to analyze clinical characteristics and prognosis in PE patients with paroxysmal AF episode. Methods. From the 391 patients with PE 31 subjects with paroxysmal AF were selected. This group was compared with patients with PE and sinus rhythm (SR) and 32 patients with PE and permanent AF. Results. Paroxysmal AF patients were the oldest. Concomitant DVT varies between groups: paroxysmal AF 32.3%, SR 49.5%, and permanent AF 28.1% (). The stroke history frequency was 4.6% SR, 12.9% paroxysmal AF, and 21.9% permanent AF (). Paroxysmal AF comparing to permanent AF and SR individuals had higher estimated SPAP (56 versus 48 versus 47 mmHg, ) and shorter ACT (58 versus 65 versus 70 ms, ). Patients with AF were more often classified into high-risk group according to revised Geneva score and sPESI than SR patients. In-hospital mortality was lower in SR (5%) and paroxysmal AF (6.5%) compared to permanent AF group (25%) (). Conclusions. Patients with PE-associated paroxysmal AF constitute a separate population. More severe impairment of the parameters reflecting RV afterload may indicate relation between PE severity and paroxysmal AF episode. Paroxysmal AF has no impact on short-term mortality.