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
References
Oct 1, 1995·Circulation·M C WijffelsM A Allessie
Jun 14, 2002·Cardiovascular Research·Maurits AllessieUlrich Schotten
Dec 6, 2002·The New England Journal of Medicine·D G WyseUNKNOWN Atrial Fibrillation Follow-up Investigation of Rhythm Management (AFFIRM) Investigators
Dec 6, 2002·The New England Journal of Medicine·Isabelle C Van GelderUNKNOWN Rate Control versus Electrical Cardioversion for Persistent Atrial Fibrillation Study Group
Mar 10, 2004·Circulation·Scott D CorleyUNKNOWN AFFIRM Investigators
May 3, 2005·American Heart Journal·Charles R KerrDavid Newman
Jun 6, 2007·Circulation·Arshad JahangirBernard J Gersh
Sep 19, 2009·Chest·Gregory Y H LipHarry J G M Crijns
Dec 17, 2009·Journal of School Psychology·Amanda N Baraldi, Craig K Enders
Feb 23, 2010·Journal of the American College of Cardiology·Cees B de VosHarry J G M Crijns
Mar 17, 2010·The New England Journal of Medicine·Isabelle C Van GelderUNKNOWN RACE II Investigators
Aug 31, 2010·European Heart Journal·A John CammFrans H Rutten
Sep 30, 2010·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·A John CammUNKNOWN ESC Committee for Practice Guidelines
Jul 23, 2011·Journal of the American College of Cardiology·A John CammWilliam Weintraub
Oct 11, 2011·American Heart Journal·Jonathan P PicciniEric D Peterson
Mar 3, 2012·Journal of Interventional Cardiac Electrophysiology : an International Journal of Arrhythmias and Pacing·Hugh CalkinsDavid Wilber
Mar 6, 2012·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Hugh CalkinsUNKNOWN Heart Rhythm Society Task Force on Catheter and Surgical Ablation of Atrial Fibrillation
May 23, 2012·American Heart Journal·Cees B De VosHarry J Crijns
Apr 9, 2013·The American Journal of Cardiology·Yuan-Yuan ZhangWilliam S Weintraub
Feb 6, 2014·JAMA : the Journal of the American Medical Association·Nassir F MarroucheJohannes Brachmann
Citations
May 18, 2016·American Heart Journal·Anna GundlundUNKNOWN ORBIT-AF Investigators
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
Apr 15, 2018·Journal of the American Heart Association·Marat FudimJonathan P Piccini
Sep 30, 2015·Hypertension·Allan D Struthers, Jacob George
Jun 21, 2017·Health Technology Assessment : HTA·Nicky J WeltonReecha Sofat
Jan 8, 2019·Open Heart·Neil A SmartRod S Taylor
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:
Dec 20, 2017·Oncotarget·Xiaoying ChenWei Wang
May 21, 2020·International Journal of Environmental Research and Public Health·Eulalia Muria-Subirats On Behalf Members Of Africat Group
Dec 17, 2016·Current Opinion in Cardiology·Robert J H Miller, Jonathan G Howlett
Oct 26, 2018·Stroke; a Journal of Cerebral Circulation·Hisashi OgawaUNKNOWN Fushimi AF Registry Investigators
Feb 28, 2019·Scientific Reports·Junbeom ParkHye Jin Hwang
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