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

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% (p=0.02). The stroke history frequency was 4.6% SR, 12.9% paroxysmal AF, and 21.9% permanent AF (p<0.001). Paroxysmal AF comparing to permanent AF and SR individuals had higher estimated SPAP (56 versus 48 versus 47 mmHg, p=0.01) and shorter ACT (58 versus 65 versus 70 ms, p=0.04). 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%) (p<0.001). 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.

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Pleural effusion as an indicator of short term mortality in acute pulmonary embolism

Tuberkuloz ve Toraks ◽

10.5578/tt.67203 ◽

2018 ◽

Vol 66 (3) ◽

pp. 185-196

Author(s):

Şehnaz Olgun Yıldızeli ◽

Umut Sabri Kasapoğlu ◽

Hüseyin Arıkan ◽

Canan Çimşit ◽

Nuri Çagatay Çimşit ◽

...

Keyword(s):

Pulmonary Embolism ◽

Pleural Effusion ◽

Acute Pulmonary Embolism ◽

Short Term ◽

Short Term Mortality

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Impact of syncope and pre-syncope on short-term mortality in patients with acute pulmonary embolism

European Journal of Internal Medicine ◽

10.1016/j.ejim.2018.04.004 ◽

2018 ◽

Vol 54 ◽

pp. 27-33 ◽

Cited By ~ 9

Author(s):

Loris Roncon ◽

Marco Zuin ◽

Franco Casazza ◽

Cecilia Becattini ◽

Claudio Bilato ◽

...

Keyword(s):

Pulmonary Embolism ◽

Acute Pulmonary Embolism ◽

Short Term ◽

Short Term Mortality

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Short-term Mortality in Acute Pulmonary Embolism: Clot Burden and Signs of Right Heart Dysfunction at CT Pulmonary Angiography

Radiology ◽

10.1148/radiol.12110802 ◽

2012 ◽

Vol 265 (1) ◽

pp. 283-293 ◽

Cited By ~ 87

Author(s):

Alessandro Furlan ◽

Ayaz Aghayev ◽

Chung-Chou H. Chang ◽

Amol Patil ◽

Kyung Nyeo Jeon ◽

...

Keyword(s):

Pulmonary Embolism ◽

Acute Pulmonary Embolism ◽

Pulmonary Angiography ◽

Ct Pulmonary Angiography ◽

Short Term ◽

Right Heart ◽

Heart Dysfunction ◽

Short Term Mortality ◽

Clot Burden ◽

Right Heart Dysfunction

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The predictive value of RS time for short term mortality in patients with acute pulmonary embolism

Journal of Electrocardiology ◽

10.1016/j.jelectrocard.2020.07.013 ◽

2020 ◽

Vol 62 ◽

pp. 94-99

Author(s):

Ayça Gümüşdağ ◽

Cengiz Burak ◽

Muhammed Süleymanoğlu ◽

Mahmut Yesin ◽

Veysel Ozan Tanık ◽

...

Keyword(s):

Pulmonary Embolism ◽

Predictive Value ◽

Acute Pulmonary Embolism ◽

Short Term ◽

Short Term Mortality

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CT-derived atrial and ventricular septal signs for risk stratification of patients with acute pulmonary embolism: clinical associations of CT-derived signs for prediction of short-term mortality

The International Journal of Cardiovascular Imaging ◽

10.1007/s10554-014-0428-6 ◽

2014 ◽

Vol 30 (S1) ◽

pp. 25-32 ◽

Cited By ~ 5

Author(s):

Mi-Jeong Kim ◽

Hae Ok Jung ◽

Jung Im Jung ◽

Ki Joon Kim ◽

Doo Soo Jeon ◽

...

Keyword(s):

Pulmonary Embolism ◽

Risk Stratification ◽

Acute Pulmonary Embolism ◽

Short Term ◽

Short Term Mortality ◽

Clinical Associations

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Does Baseline BUN Have an Additive Effect on the Prediction of Mortality in Patients with Acute Pulmonary Embolism?

The Journal of Tehran University Heart Center ◽

10.18502/jthc.v15i2.4184 ◽

2020 ◽

Author(s):

Yaser Jenab ◽

Ali-Mohammad Haji-Zeinali ◽

Mohammad Javad Alemzadeh-Ansari ◽

Shapour Shirani ◽

Mojtaba Salarifar ◽

...

Keyword(s):

Pulmonary Embolism ◽

High Risk ◽

Acute Pulmonary Embolism ◽

Low Risk ◽

Cardiac Biomarkers ◽

Operating Characteristics ◽

Short Term ◽

Prediction Of Mortality ◽

Short Term Mortality ◽

Acute Pe

Background: In patients with heart failure, elevated levels of blood urea nitrogen (BUN) is a prognostic factor. In this study, we investigated the prognostic value of elevated baseline BUN in short-term mortality among patients with acute pulmonary embolism (PE). Methods: Between 2007 and 2014, cardiac biomarkers and BUN levels were measured in patients with acute PE. The primary endpoint was 30-day mortality, evaluated based on the baseline BUN (≥14 ng/L) level in 4 groups of patients according to the European Society of Cardiology’s risk stratification (low-risk, intermediate low-risk, intermediate high-risk, and high-risk). Results: Our study recruited 492 patients with a diagnosis of acute PE (mean age=60.58±16.81 y). The overall 1-month mortality rate was 6.9% (34 patients). Elevated BUN levels were reported in 316 (64.2%) patients. A high simplified pulmonary embolism severity index (sPESI) score (OR: 5.23, 95% CI: 1.43–19.11; P=0.012), thrombolytic or thrombectomy therapy (OR: 2.42, 95% CI: 1.01–5.13; P=0.021), and elevated baseline BUN levels (OR: 1.04, 95% CI: 1.01–1.03; P=0.029) were the independent predictors of 30-day mortality. According to our receiver-operating characteristics analysis for 30-day mortality, a baseline BUN level of greater than 14.8 mg/dL was considered elevated. In the intermediate-low-risk patients, mortality occurred only in those with elevated baseline BUN levels (7.2% vs. 0; P=0.008). Conclusion: An elevated baseline BUN level in our patients with PE was an independent predictor of short-term mortality, especially among those in the intermediate-risk group.

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