Incidence and Predictors of Atrial Fibrillation Progression.
Détails
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Etat: Public
Version: Final published version
Licence: CC BY-NC-ND 4.0
Etat: Public
Version: Final published version
Licence: CC BY-NC-ND 4.0
ID Serval
serval:BIB_EB72117D06A1
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Incidence and Predictors of Atrial Fibrillation Progression.
Périodique
Journal of the American Heart Association
Collaborateur⸱rice⸱s
Swiss-AF Investigators
ISSN
2047-9980 (Electronic)
ISSN-L
2047-9980
Statut éditorial
Publié
Date de publication
15/10/2019
Peer-reviewed
Oui
Volume
8
Numéro
20
Pages
e012554
Langue
anglais
Notes
Publication types: Journal Article ; Multicenter Study ; Observational Study
Publication Status: ppublish
Publication Status: ppublish
Résumé
Background The incidence and predictors of atrial fibrillation (AF) progression are currently not well defined, and clinical AF progression partly overlaps with rhythm control interventions (RCIs). Methods and Results We assessed AF type and intercurrent RCIs during yearly follow-ups in 2869 prospectively followed patients with paroxysmal or persistent AF. Clinical AF progression was defined as progression from paroxysmal to nonparoxysmal or from persistent to permanent AF. An RCI was defined as pulmonary vein isolation, electrical cardioversion, or new treatment with amiodarone. During a median follow-up of 3 years, the incidence of clinical AF progression was 5.2 per 100 patient-years, and 10.9 per 100 patient-years for any RCI. Significant predictors for AF progression were body mass index (hazard ratio [HR], 1.03; 95% CI, 1.01-1.05), heart rate (HR per 5 beats/min increase, 1.05; 95% CI, 1.02-1.08), age (HR per 5-year increase 1.19; 95% CI, 1.13-1.27), systolic blood pressure (HR per 5 mm Hg increase, 1.03; 95% CI, 1.00-1.05), history of hyperthyroidism (HR, 1.71; 95% CI, 1.16-2.52), stroke (HR, 1.50; 95% CI, 1.19-1.88), and heart failure (HR, 1.69; 95% CI, 1.34-2.13). Regular physical activity (HR, 0.80; 95% CI, 0.66-0.98) and previous pulmonary vein isolation (HR, 0.69; 95% CI, 0.53-0.90) showed an inverse association. Significant predictive factors for RCIs were physical activity (HR, 1.42; 95% CI, 1.20-1.68), AF-related symptoms (HR, 1.84; 95% CI, 1.47-2.30), age (HR per 5-year increase, 0.88; 95% CI, 0.85-0.92), and paroxysmal AF (HR, 0.61; 95% CI, 0.51-0.73). Conclusions Cardiovascular risk factors and comorbidities were key predictors of clinical AF progression. A healthy lifestyle may therefore reduce the risk of AF progression.
Mots-clé
Aged, Atrial Fibrillation/epidemiology, Atrial Fibrillation/physiopathology, Body Mass Index, Disease Progression, Electrocardiography/methods, Female, Follow-Up Studies, Heart Rate/physiology, Humans, Incidence, Male, Prospective Studies, Risk Assessment/methods, Risk Factors, Switzerland/epidemiology, atrial fibrillation, epidemiology, predictors, progression, rhythm control
Pubmed
Web of science
Open Access
Oui
Création de la notice
10/10/2019 21:11
Dernière modification de la notice
23/04/2024 6:17