Temporal patterns and short-term progression of paroxysmal atrial fibrillation data from RACE V

Ruben R. De With; Omer Erkuner; Michiel Rienstra; Bao-Oanh Nguyen; Frank W. J. Korver; Dominik Linz; Hugo Cate Ten; Henri Spronk; Abraham A. Kroon; Alexander H. Maass; Yuri Blaauw; Robert G. Tieleman; Martin E. W. Hemels; Joris R. de Groot; Arif Elvan; Mirko de Melis; Coert O. S. Scheerder; Meelad I. H. Al-Jazairi; Ulrich Schotten; Justin G. L. M. Luermans; Harry J. G. M. Crijns; Isabelle C. Van Gelder; RACE V Investigators

doi:10.1093/europace/euaa123

Temporal patterns and short-term progression of paroxysmal atrial fibrillation data from RACE V

Ruben R. De With, Omer Erkuner, Michiel Rienstra, Bao-Oanh Nguyen, Frank W. J. Korver, Dominik Linz, Hugo Cate Ten, Henri Spronk, Abraham A. Kroon, Alexander H. Maass, Yuri Blaauw, Robert G. Tieleman, Martin E. W. Hemels, Joris R. de Groot, Arif Elvan, Mirko de Melis, Coert O. S. Scheerder, Meelad I. H. Al-Jazairi, Ulrich Schotten, Justin G. L. M. LuermansHarry J. G. M. Crijns, Isabelle C. Van Gelder^*, RACE V Investigators

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

27 Citations (Web of Science)

Abstract

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.

Original language	English
Pages (from-to)	1162-1172
Number of pages	11
Journal	EP Europace
Volume	22
Issue number	8
DOIs	https://doi.org/10.1093/europace/euaa123
Publication status	Published - Aug 2020

Keywords

Atrial fibrillation
Rhythm monitoring
Paroxysmal atrial fibrillation
Atrial fibrillation progression
Atrial fibrillation burden
RISK
STROKE
MANAGEMENT

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Cite this

De With, R. R., Erkuner, O., Rienstra, M., Nguyen, B-O., Korver, F. W. J., Linz, D., Ten, H. C., Spronk, H., Kroon, A. A., Maass, A. H., Blaauw, Y., Tieleman, R. G., Hemels, M. E. W., de Groot, J. R., Elvan, A., de Melis, M., Scheerder, C. O. S., Al-Jazairi, M. I. H., Schotten, U., ... RACE V Investigators (2020). Temporal patterns and short-term progression of paroxysmal atrial fibrillation data from RACE V. EP Europace, 22(8), 1162-1172. https://doi.org/10.1093/europace/euaa123

@article{163d783329b540879f378930c5afb7c6,

title = "Temporal patterns and short-term progression of paroxysmal atrial fibrillation data from RACE V",

abstract = "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.",

keywords = "Atrial fibrillation, Rhythm monitoring, Paroxysmal atrial fibrillation, Atrial fibrillation progression, Atrial fibrillation burden, RISK, STROKE, MANAGEMENT",

author = "{De With}, {Ruben R.} and Omer Erkuner and Michiel Rienstra and Bao-Oanh Nguyen and Korver, {Frank W. J.} and Dominik Linz and Ten, {Hugo Cate} and Henri Spronk and Kroon, {Abraham A.} and Maass, {Alexander H.} and Yuri Blaauw and Tieleman, {Robert G.} and Hemels, {Martin E. W.} and {de Groot}, {Joris R.} and Arif Elvan and {de Melis}, Mirko and Scheerder, {Coert O. S.} and Al-Jazairi, {Meelad I. H.} and Ulrich Schotten and Luermans, {Justin G. L. M.} and Crijns, {Harry J. G. M.} and {Van Gelder}, {Isabelle C.} and {RACE V Investigators}",

note = "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: {\textcopyright} The Author(s) 2020. Published by Oxford University Press on behalf of the European Society of Cardiology.",

year = "2020",

month = aug,

doi = "10.1093/europace/euaa123",

language = "English",

volume = "22",

pages = "1162--1172",

journal = "EP Europace",

issn = "1099-5129",

publisher = "Oxford University Press",

number = "8",

}

De With, RR, Erkuner, O, Rienstra, M, Nguyen, B-O, Korver, FWJ, Linz, D , Ten, HC , Spronk, H , Kroon, AA, Maass, AH, Blaauw, Y, Tieleman, RG, Hemels, MEW, de Groot, JR, Elvan, A, de Melis, M, Scheerder, COS, Al-Jazairi, MIH, Schotten, U , Luermans, JGLM , Crijns, HJGM, Van Gelder, IC & RACE V Investigators 2020, 'Temporal patterns and short-term progression of paroxysmal atrial fibrillation data from RACE V', EP Europace, vol. 22, no. 8, pp. 1162-1172. https://doi.org/10.1093/europace/euaa123

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 -