Relevancia de la fibrilación auricular en la endocarditis infecciosa

Résumé

Atrial fibrillation (AF) is the most common cardiac arrhythmia in adults and has been independently related to increased morbidity and mortality. In particular, AF has been associated with complications such as ischemic stroke, and heart failure. It is also well known the association between new-onset atrial fibrillation (NAF) and mortality in patients hospitalized with severe sepsis or heart failure. Infective endocarditis (IE) is a severe infectious disease producing a great systemic inflammatory reaction and local valve destruction leading to severe hemodynamic changes. Not surprisingly, AF is common in IE, sometimes co-existing with heart failure and systemic embolism. Nevertheless, there are no data on how AF affects the clinical outcome of patients with IE. Hypothesis 1. Development of NAF during the active phase of IE would have prognostic implications. Patients with IE and NAF have a worse clinical outcome than those who remain in sinus rhythm. 2. Patients with NAF might be particularly prone to congestive heart failure and thrombo-embolic events. Objectives 1. To investigate patient characteristics, microbiology, and echocardiographic findings of episodes with IE and NAF. We further aim to compare the in-hospital course and prognosis of patients who develop de novo AF with that of those who remained in sinus rhythm or had previous AF. 2. To study the clinical course and in-hospital events of patients with IE from each group. 3. To estimate the potential effect of NAF over in-hospital prognosis and mortality. 4. To evaluate the clinical impact of AF (new-onset and previous AF) over the risk of heart failure and systemic embolism in patients with IE. 5. To explore interactions between NAF and heart failure in IE and its prognostic impact over in-hospital mortality of patients with IE...