Data on the prevalence/incidence, risk factors, and prognosis of atrial fibrillation (AF) in patients with acute pulmonary embolism (aPE) were summarised in the study.

MEDLINE, Embase, and Web of Science were used to find all published studies with relevant data up to December 12, 2021. Estimates were pooled using the random-effects meta-analysis approach.

They included 27 studies that reported data from a total of 819,380 patients. The prevalence rates for pre-existing AF were 11.3%, 4.7% for newly diagnosed AF, and 13.2% for prevalent (total) AF. Congestive heart failure (aOR 3.33, 95% CI: 1.81-6.12), ischemic heart disease (aOR 3.25, 95% CI: 1.65-6.39), and major PE (aOR 2.67, 95% CI: 1.19-5.99) were all found to be predictors of newly diagnosed AF in one research. Overall, AF was linked to an elevated risk of both short-term (aOR 1.54, 95% CI: 1.44-1.64) and long-term mortality (aOR 1.58, 95% CI: 1.26-1.97). Pre-existing AF (aOR 1.90, 95% CI: 1.59-2.27), newly diagnosed AF (aOR 1.51, 95% CI: 1.18-1.93), and prevalent AF (aOR 1.50, 95% CI: 1.42-1.60) were all linked to an elevated risk of short-term death in subgroup analyses. Pre-existing atrial fibrillation (aOR 2.08, 95% CI: 1.27-3.42) and prevalent atrial fibrillation (aOR 1.29, 95% CI: 1.02-1.63) were also linked to increased long-term mortality.

AF is seen in approximately one out of every eight individuals with aPE and is linked with an elevated risk of short- and long-term mortality. AF may help with risk stratification in aPE patients.