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

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Fältnamn	Indikatorer	Metadata
000		03934naa a2200481 4500
001		oai:lup.lub.lu.se:2f96c66f-a956-4042-b0ee-302435da9545
003		SwePub
008		160401s2015 \| \|\|\|\|\|\|\|\|\|\|\|000 \|\|eng\|
024	7	a https://lup.lub.lu.se/record/74251942 URI
024	7	a https://doi.org/10.1136/heartjnl-2014-3070432 DOI
040		a (SwePub)lu
041		a engb eng
042		9 SwePub
072	7	a art2 swepub-publicationtype
072	7	a ref2 swepub-contenttype
100	1	a Holmqvist, Fredriku Lund University,Lunds universitet,Kardiologi,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Cardiology,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine,Duke University4 aut0 (Swepub:lu)kard-fho
245	1 0	a Heart rate is associated with progression of atrial fibrillation, independent of rhythm
264		c 2015-03-02
264	1	b BMJ,c 2015
338		a electronic2 rdacarrier
520		a Objective 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. Methods 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 CHA(2)DS(2)VASc scores for identifying AF progression. Results 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 (CHADS(2) 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 decrease <= 80) were less likely to progress. There was no significant interaction between rhythm on baseline ECG and heart rate (p=0.71). The HATCH and CHA(2)DS(2)VASc scores had modest discriminatory power for AF progression (C-indices 0.55 (95% CI 0.53 to 0.58) and 0.55 (95% CI 0.52 to 0.57)). Conclusions Within 1.5 years, almost a quarter of the patients with paroxysmal or persistent AF progress to a more sustained form. Progression is strongly associated with heart rate, and age.
650	7	a MEDICIN OCH HÄLSOVETENSKAPx Klinisk medicinx Kardiologi0 (SwePub)302062 hsv//swe
650	7	a MEDICAL AND HEALTH SCIENCESx Clinical Medicinex Cardiac and Cardiovascular Systems0 (SwePub)302062 hsv//eng
700	1	a Kim, Sunghee4 aut
700	1	a Steinberg, Benjamin A.4 aut
700	1	a Reiffel, James A.4 aut
700	1	a Mahaffey, Kenneth W.4 aut
700	1	a Gersh, Bernard J.4 aut
700	1	a Fonarow, Gregg C.4 aut
700	1	a Naccarelli, Gerald V.4 aut
700	1	a Chang, Paul4 aut
700	1	a Freeman, James V.4 aut
700	1	a Kowey, Peter R.4 aut
700	1	a Thomas, Laine4 aut
700	1	a Peterson, Eric D.4 aut
700	1	a Piccini, Jonathan P.4 aut
710	2	a Kardiologib Sektion II4 org
773	0	t Heartd : BMJg 101:11, s. 894-899q 101:11<894-899x 1355-6037x 1468-201X
856	4	u https://portal.research.lu.se/files/1512035/8522622x primaryx freey FULLTEXT
856	4	u http://dx.doi.org/10.1136/heartjnl-2014-307043x freey FULLTEXT
856	4	u https://europepmc.org/articles/pmc4453487?pdf=render
856	4 8	u https://lup.lub.lu.se/record/7425194
856	4 8	u https://doi.org/10.1136/heartjnl-2014-307043

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Av författaren/redakt...: Holmqvist, Fredr ...; Kim, Sunghee; Steinberg, Benja ...; Reiffel, James A ...; Mahaffey, Kennet ...; Gersh, Bernard J ...; visa fler...; Fonarow, Gregg C ...; Naccarelli, Gera ...; Chang, Paul; Freeman, James V ...; Kowey, Peter R.; Thomas, Laine; Peterson, Eric D ...; Piccini, Jonatha ...; visa färre...

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MEDICIN OCH HÄLSOVETENSKAP: MEDICIN OCH HÄLS ...; och Klinisk medicin; och Kardiologi

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Av lärosätet: Lunds universitet

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