Atrial fibrillation patterns are associated with arrhythmia progression and clinical outcomes

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Atrial fibrillation patterns are associated with arrhythmia progression and clinical outcomes. / Schnabel, Renate B.; Pecen, Ladislav; Engler, Daniel; Lucerna, Markus; Sellal, Jean Marc; Ojeda, Francisco M.; De Caterina, Raffaele; Kirchhof, Paulus.

In: Heart, 17.03.2018.

Research output: Contribution to journalArticlepeer-review

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APA

Schnabel, R. B., Pecen, L., Engler, D., Lucerna, M., Sellal, J. M., Ojeda, F. M., De Caterina, R., & Kirchhof, P. (2018). Atrial fibrillation patterns are associated with arrhythmia progression and clinical outcomes. Heart. https://doi.org/10.1136/heartjnl-2017-312569

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Author

Schnabel, Renate B. ; Pecen, Ladislav ; Engler, Daniel ; Lucerna, Markus ; Sellal, Jean Marc ; Ojeda, Francisco M. ; De Caterina, Raffaele ; Kirchhof, Paulus. / Atrial fibrillation patterns are associated with arrhythmia progression and clinical outcomes. In: Heart. 2018.

Bibtex

@article{ca3906673e3443119d1aef45955eb7e6,
title = "Atrial fibrillation patterns are associated with arrhythmia progression and clinical outcomes",
abstract = "OBJECTIVES: Determinants of atrial fibrillation (AF) patterns and of progression of earlier forms to permanent AF, and their relationship with outcome are still poorly understood.METHODS: We examined AF patterns (paroxysmal, persistent and permanent), rate and predictors of AF progression, and outcomes in the PREFER (PREvention oF thromboembolic events-European Registry) in AF. The primary analysis was performed in the PREFER in AF prolongation dataset (n=3223 patients with AF with a complete 1-year follow-up, mean age 72±9 years, 40% women). Sensitivity analyses were performed using the PREFER in the AF study (n=6390 patients).RESULTS: AF progressed to more persistent types in 506 patients (17%). Permanent AF was associated with development of heart failure at 1 year (OR 1.80, 95% CI 1.06 to 3.07, p=0.03) compared with paroxysmal AF, which was confirmed in the entire cohort. In multivariable-adjusted models, sinus rhythm at baseline, AF duration, cardioversion, hyperthyroidism, valvular heart disease, diabetes mellitus and heart failure were predictors of AF progression (area under the receiver operating characteristic curve 0.60, 95% CI 0.57 to 0.63). Results were similar when we restricted analyses to patients with AF duration <1 year. AF progression showed an association with coronary events over 1 year (OR 2.27, 95% CI 1.22 to 4.19, p=0.0074).CONCLUSIONS: Permanent AF at baseline was associated with incident heart failure. A substantial proportion of well-managed patients with AF showed AF progression over 1 year. AF progression itself was not strongly related to outcome and may indicate the need to refine the current classification of AF types to enhance clinical utility.",
keywords = "Journal Article",
author = "Schnabel, {Renate B.} and Ladislav Pecen and Daniel Engler and Markus Lucerna and Sellal, {Jean Marc} and Ojeda, {Francisco M.} and {De Caterina}, Raffaele and Paulus Kirchhof",
note = "{\textcopyright} Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.",
year = "2018",
month = mar,
day = "17",
doi = "10.1136/heartjnl-2017-312569",
language = "English",
journal = "Heart",
issn = "1355-6037",
publisher = "BMJ Publishing Group",

}

RIS

TY - JOUR

T1 - Atrial fibrillation patterns are associated with arrhythmia progression and clinical outcomes

AU - Schnabel, Renate B.

AU - Pecen, Ladislav

AU - Engler, Daniel

AU - Lucerna, Markus

AU - Sellal, Jean Marc

AU - Ojeda, Francisco M.

AU - De Caterina, Raffaele

AU - Kirchhof, Paulus

N1 - © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

PY - 2018/3/17

Y1 - 2018/3/17

N2 - OBJECTIVES: Determinants of atrial fibrillation (AF) patterns and of progression of earlier forms to permanent AF, and their relationship with outcome are still poorly understood.METHODS: We examined AF patterns (paroxysmal, persistent and permanent), rate and predictors of AF progression, and outcomes in the PREFER (PREvention oF thromboembolic events-European Registry) in AF. The primary analysis was performed in the PREFER in AF prolongation dataset (n=3223 patients with AF with a complete 1-year follow-up, mean age 72±9 years, 40% women). Sensitivity analyses were performed using the PREFER in the AF study (n=6390 patients).RESULTS: AF progressed to more persistent types in 506 patients (17%). Permanent AF was associated with development of heart failure at 1 year (OR 1.80, 95% CI 1.06 to 3.07, p=0.03) compared with paroxysmal AF, which was confirmed in the entire cohort. In multivariable-adjusted models, sinus rhythm at baseline, AF duration, cardioversion, hyperthyroidism, valvular heart disease, diabetes mellitus and heart failure were predictors of AF progression (area under the receiver operating characteristic curve 0.60, 95% CI 0.57 to 0.63). Results were similar when we restricted analyses to patients with AF duration <1 year. AF progression showed an association with coronary events over 1 year (OR 2.27, 95% CI 1.22 to 4.19, p=0.0074).CONCLUSIONS: Permanent AF at baseline was associated with incident heart failure. A substantial proportion of well-managed patients with AF showed AF progression over 1 year. AF progression itself was not strongly related to outcome and may indicate the need to refine the current classification of AF types to enhance clinical utility.

AB - OBJECTIVES: Determinants of atrial fibrillation (AF) patterns and of progression of earlier forms to permanent AF, and their relationship with outcome are still poorly understood.METHODS: We examined AF patterns (paroxysmal, persistent and permanent), rate and predictors of AF progression, and outcomes in the PREFER (PREvention oF thromboembolic events-European Registry) in AF. The primary analysis was performed in the PREFER in AF prolongation dataset (n=3223 patients with AF with a complete 1-year follow-up, mean age 72±9 years, 40% women). Sensitivity analyses were performed using the PREFER in the AF study (n=6390 patients).RESULTS: AF progressed to more persistent types in 506 patients (17%). Permanent AF was associated with development of heart failure at 1 year (OR 1.80, 95% CI 1.06 to 3.07, p=0.03) compared with paroxysmal AF, which was confirmed in the entire cohort. In multivariable-adjusted models, sinus rhythm at baseline, AF duration, cardioversion, hyperthyroidism, valvular heart disease, diabetes mellitus and heart failure were predictors of AF progression (area under the receiver operating characteristic curve 0.60, 95% CI 0.57 to 0.63). Results were similar when we restricted analyses to patients with AF duration <1 year. AF progression showed an association with coronary events over 1 year (OR 2.27, 95% CI 1.22 to 4.19, p=0.0074).CONCLUSIONS: Permanent AF at baseline was associated with incident heart failure. A substantial proportion of well-managed patients with AF showed AF progression over 1 year. AF progression itself was not strongly related to outcome and may indicate the need to refine the current classification of AF types to enhance clinical utility.

KW - Journal Article

U2 - 10.1136/heartjnl-2017-312569

DO - 10.1136/heartjnl-2017-312569

M3 - Article

C2 - 29550771

JO - Heart

JF - Heart

SN - 1355-6037

ER -