TY - JOUR
T1 - Temporal patterns and short-term progression of paroxysmal atrial fibrillation data from RACE V
AU - De With, Ruben R.
AU - Erkuner, Omer
AU - Rienstra, Michiel
AU - Nguyen, Bao-Oanh
AU - Korver, Frank W. J.
AU - Linz, Dominik
AU - Ten, Hugo Cate
AU - Spronk, Henri
AU - Kroon, Abraham A.
AU - Maass, Alexander H.
AU - Blaauw, Yuri
AU - Tieleman, Robert G.
AU - Hemels, Martin E. W.
AU - de Groot, Joris R.
AU - Elvan, Arif
AU - de Melis, Mirko
AU - Scheerder, Coert O. S.
AU - Al-Jazairi, Meelad I. H.
AU - Schotten, Ulrich
AU - Luermans, Justin G. L. M.
AU - Crijns, Harry J. G. M.
AU - Van Gelder, Isabelle C.
AU - RACE V Investigators
N1 - Funding Information:
We acknowledge the support from the Netherlands Cardiovascular Research Initiative: an initiative with support of the Dutch Heart Foundation, CVON 2014-9: Reappraisal of Atrial Fibrillation: interaction between hyperCoagulability, Electrical remodelling, and Vascular destabilisation in the progression of AF (RACE V), and grant support from Medtronic to the institution.
Publisher Copyright:
© The Author(s) 2020. Published by Oxford University Press on behalf of the European Society of Cardiology.
PY - 2020/8
Y1 - 2020/8
N2 - 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, CHA(2)DS(2)-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.Conclusion 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.
AB - 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, CHA(2)DS(2)-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.Conclusion 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.
KW - Atrial fibrillation
KW - Rhythm monitoring
KW - Paroxysmal atrial fibrillation
KW - Atrial fibrillation progression
KW - Atrial fibrillation burden
KW - RISK
KW - STROKE
KW - MANAGEMENT
U2 - 10.1093/europace/euaa123
DO - 10.1093/europace/euaa123
M3 - Article
C2 - 32642768
SN - 1099-5129
VL - 22
SP - 1162
EP - 1172
JO - EP Europace
JF - EP Europace
IS - 8
ER -