Trends, Associations, and Impact of Atrial Fibrillation in Patients with Light Chain Cardiac Amyloidosis.

Background In this study, we investigated the temporal trends in the prevalence and prognostic implication of atrial fibrillation (AF) in patient with light-chain cardiac amyloidosis (AL-CA). Methods We identified 3030 patients with AL-CA from the 2015 to 2017 National Inpatient Sample, of which 1,577 (52%) had AF. We used trend analysis to assess the temporal trends in the prevalence of AF by subtype from 2015 to 2017. We compared in-hospital mortality, acute on chronic heart failure, stroke, length of stay (LOS), and total cost in patients with to those without AF, stratified by subtype of AF. Results The prevalence of AF among patients with AL-CA was unchanged from 2015 to 2017 (50% to 53%; aOR 1.1 (0.9 - 1.5) p=0.3). The trend was unchanged in the stratified analysis by subtype of AF. Patients with AF were older and had more comorbidities. After propensity matching, acute on chronic heart failure was significantly higher in patients with AL-CA and AF, compared to those with AL-CA alone. (55.6% vs 48.3%; p Conclusion Among patients with AL-CA, AF is associated with a higher risk of acute on chronic heart failure.