Heart rate is associated with progression of atrial fibrillation, independent of rhythm

Heart
Fredrik HolmqvistORBIT-AF Investigators

Abstract

Atrial fibrillation (AF) often progresses from paroxysmal or persistent to more sustained forms, but the rate and predictors of AF progression in clinical practice are not well described. Using the Outcomes Registry for Better Informed Treatment of AF, we analysed the incidence and predictors of progression and tested the discrimination and calibration of the HATCH (hypertension, age, TIA/stroke, chronic obstructive pulmonary disease, heart failure) and CHA₂DS₂VASc scores for identifying AF progression. Among 6235 patients with paroxysmal or persistent AF at baseline, 1479 progressed, during follow-up (median 18 (IQR 12-24) months). These patients were older and had more comorbidities than patients who did not progress (CHADS₂ 2.3±1.3 vs 2.1±1.3, p<0.0001). At baseline, patients with AF progression were more often on a rate control as opposed to a rhythm control strategy (66 vs 56%, p<0.0001) and had higher heart rate (72(64-80) vs 68(60-76) bpm, p<0.0001). The strongest predictors of AF progression were AF on the baseline ECG (OR 2.30, 95% CI 1.95 to 2.73, p<0.0001) and increasing age (OR 1.16, 95% CI1.09 to 1.24, p<0.0001, per 10 increase), while patients with lower heart rate (OR 0.84, 95% CI 0.79 to 0.89, p<0.0001, per 10 d...Continue Reading

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Citations

Jan 23, 2016·Heart·Muhammad Jawad-Ul-Qamar, Paulus Kirchhof
Jul 9, 2016·European Heart Journal·Paulus Kirchhof, Hugh Calkins
Nov 11, 2016·International Journal of Cardiology·Emily J Callander, Robyn McDermott
Jun 3, 2017·Heart·Andrea IsaewTom Marshall
Jun 21, 2017·Health Technology Assessment : HTA·Nicky J WeltonReecha Sofat
Oct 11, 2017·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Hugh CalkinsUNKNOWN Document Reviewers:
May 21, 2020·International Journal of Environmental Research and Public Health·Eulalia Muria-Subirats On Behalf Members Of Africat Group
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Feb 20, 2020·Journal of Arrhythmia·Eric Black-MaierJonathan P Piccini
Oct 9, 2019·Journal of the American Heart Association·Steffen BlumUNKNOWN Swiss‐AF Investigators
Nov 22, 2018·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Jonathan P PicciniNiraj Varma
Dec 4, 2020·Journal of Cardiovascular Electrophysiology·Wang-Yang YangUNKNOWN Chinese Atrial Fibrillation Registry Study Group
Jun 4, 2019·Journal of Electrocardiology·Cynthia YeungAdrian Baranchuk
Jun 23, 2021·Clinical Research in Cardiology : Official Journal of the German Cardiac Society·Peter HämmerleChristine S Zuern

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