LAUSR

Introduction: The prevalence of atrial fibrillation (AF) in patients with cardiac amyloidosis (CA) can be as high as 40%, depending on the amyloid protein involved. There is a lack of data, however, concerning the temporal trends and prognostic implications of AF in these patients. Hypothesis: AF is associated with worse outcomes in patients with CA Methods: We identified 21,661 patients with the primary diagnosis of CA from the 2006 to 2014 National Inpatient Sample, of which 5,279 (25%) had AF. We used trend analysis to assess the temporal trends in the prevalence of AF from 2006 to 2014. We compared overall mortality, stroke, length of stay (LOS), and total cost in patients with those without AF. Results: The prevalence of AF increased from 1.3% in 2006 to 17.7% in 2014 (p<0.0001). Patients with AF were older and had more comorbidities. After propensity matching, overall mortality (8.7% vs 7.5%; p= 0.027) and rates of stroke (21.0% vs 18.0%; p<0.0001) were significantly higher in patients with CA and AF, compared to those with CA alone. There was no difference in median LOS (5 (3,9) vs 5(3,10); p= 0.065) and median total hospital cost ($36163 vs $34706; p= 0.114). The strongest predictors for overall mortality were hemodialysis, stroke, cardiac arrest, and congestive heart failure. Conclusions: Over a decade period, the prevalence of AF increased among CA patients and was associated with a higher risk of stroke and overall mortality.