Persistent Atrial Fibrillation From the Onset: A Specific Subgroup of Patients With Biatrial Substrate Involvement and Poorer Clinical Outcome

JACC. Clinical Electrophysiology
Han S LimMichel Haïssaguerre

Abstract

This study sought to characterize the clinical characteristics, atrial substrate, and prognosis in a subgroup of patients with persistent atrial fibrillation (AF) from the onset (PsAFonset). Patients with AF frequently progress from trigger-driven paroxysmal arrhythmias to substrate-dependent persistent arrhythmias. Patients referred for persistent AF (PsAF) ablation were enrolled from 3 centers. Consecutive patients with PsAFonset (n = 129) were compared with patients with PsAF that progressed from paroxysmal AF (n = 231). In addition, 90 patients (30 patients with PsAFonset and 60 control subjects) were studied with noninvasive mapping to characterize the AF drivers. The degree of fractionation and endocardial voltages were assessed invasively. Patients with PsAFonset were younger (p = 0.047) and more obese (p < 0.001); there were more men (p = 0.034), more patients with hypertension (p = 0.044), and these patients had larger left (p < 0.05) and right atria (p < 0.05). Baseline AF cycle length was shorter in the PsAFonset group (p < 0.01); the degree of fractionation was higher (p < 0.001 for both atria), and the endocardial voltage was lower (p < 0.05 for both atria). Patients with PsAFonset had higher a number of re-entrant...Continue Reading

References

Sep 3, 1998·The New England Journal of Medicine·M HaïssaguerreJ Clémenty
Jun 27, 2000·Journal of Cardiovascular Electrophysiology·P JaïsJ Clémenty
Jan 13, 2004·Journal of the American College of Cardiology·Carsten W IsraelStefan H Hohnloser
Jul 1, 2004·Circulation·D George Wyse, Bernard J Gersh
Sep 4, 2007·Journal of Cardiovascular Electrophysiology·Shih-Lin ChangShih-Ann Chen
Jul 16, 2008·European Heart Journal·Bobby JohnPrashanthan Sanders
Apr 4, 2009·Journal of the American College of Cardiology·Martin K StilesPrashanthan Sanders
Feb 23, 2010·Journal of the American College of Cardiology·Cees B de VosHarry J G M Crijns
May 15, 2010·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Dennis H LauPrashanthan Sanders
Jun 17, 2010·Circulation. Arrhythmia and Electrophysiology·Steven A LubitzPatrick T Ellinor
Nov 15, 2011·Journal of the American College of Cardiology·Pyotr G PlatonovSiew Yen Ho
Nov 15, 2011·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Andrew W TehJonathan M Kalman
Nov 16, 2011·Circulation·Yu-ki IwasakiStanley Nattel
Apr 10, 2012·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Anthony G BrooksPrashanthan Sanders
Oct 16, 2012·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Hany S AbedPrashanthan Sanders
Dec 21, 2012·Journal of Cardiovascular Electrophysiology·Sonia AmmarIsabel Deisenhofer
Apr 18, 2013·Nature Reviews. Cardiology·Dawood Darbar, Dan M Roden
Feb 6, 2014·JAMA : the Journal of the American Medical Association·Nassir F MarroucheJohannes Brachmann
Jul 17, 2014·Circulation·Michel HaissaguerreRemi Dubois
Dec 3, 2014·Journal of the American College of Cardiology·Rajeev K PathakPrashanthan Sanders

❮ Previous
Next ❯

Citations

Mar 19, 2019·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·Andreas GoetteUNKNOWN ESC Scientific Document Group
Aug 5, 2016·Nature Reviews. Cardiology·Stanley Nattel, Dobromir Dobrev
Jul 11, 2021·Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography·Aditya BhatTimothy C Tan

❮ Previous
Next ❯

Related Concepts

Related Feeds

Arrhythmia

Arrhythmias are abnormalities in heart rhythms, which can be either too fast or too slow. They can result from abnormalities of the initiation of an impulse or impulse conduction or a combination of both. Here is the latest research on arrhythmias.

Atrial Fibrillation

Atrial fibrillation is a common arrhythmia that is associated with substantial morbidity and mortality, particularly due to stroke and thromboembolism. Here is the latest research.

Atrial Filbrillation

Atrial fibrillation refers to the abnormal heart rhythm characterized by rapid and irregular beating of the atria. Here is the latest research.