Prognosis

The prognosis depends on several factors, such as the precipitating event, underlying cardiac status, risk of thromboembolism, and whether the nature of the AF is paroxysmal, persistent, or permanent. Almost 25% of patients with paroxysmal or persistent AF progress to a more sustained form within 1.5 years, whereby heart rate and age are strong predictors for AF progression.[189] Short- and long-term prognosis for patients presenting with new onset of AF and its relation to heart failure following myocardial infarction (MI) is poor. One large Swedish cohort study involving patients hospitalised for MI has found a 30% higher risk of cardiovascular events (i.e., all-cause mortality, MI, and ischaemic stroke) among those presenting with AF (all types) compared with those in sinus rhythm.[190] Patients with MI who also present with AF need close clinical follow-up.

Studies in patients with a cardiac implantable electronic device (CIED) have shown that increased burden of AF (detected by the CIED) is associated with an increased risk of adverse outcomes, including all-cause mortality.[191][192]​

Asymptomatic clinical AF has been independently associated with increased risk of stroke and mortality compared with symptomatic AF.[2]

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