Temporal patterns and short-term progression of paroxysmal atrial fibrillation: data from RACE V
| Autor: | Ulrich Schotten, Hugo ten Cate, Bao-Oanh Nguyen, Michiel Rienstra, Isabelle C. Van Gelder, Arif Elvan, Race V Investigators, Mirko De Melis, Alexander H. Maass, Joris R de Groot, Martin E.W. Hemels, Abraham A. Kroon, Harry J.G.M. Crijns, Coert O S Scheerder, Henri M. H. Spronk, Justin G.L.M. Luermans, Ömer Erküner, Dominik Linz, Yuri Blaauw, Frank W J Körver, Robert G. Tieleman, Meelad I H Al-Jazairi |
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| Přispěvatelé: | Cardiologie, MUMC+: MA Med Staf Spec Cardiologie (9), MUMC+: MA Med Staf Artsass Cardiologie (9), RS: Carim - H08 Experimental atrial fibrillation, MUMC+: HVC Trombosezorg (8), RS: Carim - B04 Clinical thrombosis and Haemostasis, MUMC+: HVC Pieken Trombose (9), MUMC+: MA Alg Interne Geneeskunde (9), Interne Geneeskunde, RS: Carim - V02 Hypertension and target organ damage, Fysiologie, RS: Carim - H01 Clinical atrial fibrillation, MUMC+: MA Cardiologie (9), Cardiology, ACS - Heart failure & arrhythmias |
| Rok vydání: | 2020 |
| Předmět: |
Male
medicine.medical_specialty Pacemaker Artificial Vascular damage Radboud Institute for Health Sciences [Radboudumc 16] Carotid Intima-Media Thickness Coronary artery disease Atrial fibrillation progression Clinical Research Physiology (medical) Internal medicine Atrial Fibrillation MANAGEMENT medicine Implantable loop recorder Humans Registries Stroke Aged RISK Heart Failure Rhythm monitoring Paroxysmal atrial fibrillation business.industry Atrial fibrillation Middle Aged medicine.disease Interim analysis Comorbidity Atrial fibrillation burden Intima-media thickness Heart failure Cardiology Disease Progression Female Cardiology and Cardiovascular Medicine business STROKE |
| Zdroj: | Europace, 22, 1162-72 Europace Europace, 22, 8, pp. 1162-72 EP Europace, 22(8), 1162-1172. Oxford University Press |
| ISSN: | 1099-5129 1532-2092 |
| Popis: | Aims Atrial fibrillation (AF) often starts as a paroxysmal self-terminating arrhythmia. Limited information is available on AF patterns and episode duration of paroxysmal AF. In paroxysmal AF patients, we longitudinally studied the temporal AF patterns, the association with clinical characteristics, and prevalence of AF progression. Methods and results In this interim analysis of the Reappraisal of AF: Interaction Between HyperCoagulability, Electrical Remodelling, and Vascular Destabilisation in the Progression of AF (RACE V) registry, 202 patients with paroxysmal AF were followed with continuous rhythm monitoring (implantable loop recorder or pacemaker) for 6 months. Mean age was 64 ± 9 years, 42% were women. Atrial fibrillation history was 2.1 (0.5–4.4) years, CHA2DS2-VASc 1.9 ± 1.3, 101 (50%) had hypertension, 69 (34%) heart failure. One-third had no AF during follow-up. Patients with long episodes (>12 hours) were often men with more comorbidities (heart failure, coronary artery disease, higher left ventricular mass). Patients with higher AF burden (>2.5%) were older with more comorbidities (worse renal function, higher calcium score, thicker intima media thickness). In 179 (89%) patients, 1-year rhythm follow-up was available. On a quarterly basis, average daily AF burden increased from 3.2% to 3.8%, 5.2%, and 6.1%. Compared to the first 6 months, 111 (62%) patients remained stable during the second 6 months, 39 (22%) showed progression to longer AF episodes, 8 (3%) developed persistent AF, and 29 (16%) patients showed AF regression. Conclusions In paroxysmal AF, temporal patterns differ suggesting that paroxysmal AF is not one entity. Atrial fibrillation burden is low and determined by number of comorbidities. Atrial fibrillation progression occurred in a substantial number. Trial registration number Clinicaltrials.gov identifier NCT02726698. |
| Databáze: | OpenAIRE |
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