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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Progression of atrial fibrillation in the REgistry on Cardiac rhythm disORDers assessing the control of Atrial Fibrillation cohort: Clinical correlates and the effect of rhythm-control therapy
American Heart Journal, Volume 163, No. 5, Year 2012
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Description
Introduction: Paroxysmal atrial fibrillation (AF) may progress to persistent AF. We studied the clinical correlates and the effect of rhythm-control strategy on AF progression. Methods: RecordAF was a worldwide prospective survey of AF management. Consecutive eligible patients with recent-onset AF were included and allocated to rate or rhythm control according to patient/physician choice. A total of 2,137 patients were followed up for 12 months. Atrial fibrillation progression was defined as a change from paroxysmal to persistent/permanent AF. Results: Progression of AF occurred in 318 patients (15%) after 1 year. Patients with AF progression were older; had a higher diastolic blood pressure; and more often had a history of coronary artery disease, stroke or transient ischemic attack, hypertension, or heart failure. Patients treated with rhythm control were less likely to show progression than those treated only with rate control (164/1542 [11%] vs 154/595 [26%], P <.001). Multivariable analysis showed that history of heart failure (odds ratio [OR] 2.2, 95% CI 1.7-2.9, P <.0001), history of hypertension (OR 1.5, 95% CI 1.1-2.0, P =.01), and rate control rather than rhythm control (OR 3.2, 95% CI 2.5-4.1, P <.0001) were independent predictors of AF progression. The propensity score-adjusted OR of AF progression in patients with rate rather than rhythm control was 3.3 (95% CI 2.4-4.6, P <.0001). Conclusions: Although heart failure and hypertension are associated with AF progression, rhythm control is associated with lower risk of AF progression. © 2012 Mosby, Inc.
Authors & Co-Authors
De Vos, Cees B.
Netherlands, Maastricht
Universiteit Maastricht
Breithardt, Gu¨nter E.
Germany, Munster
Universitätsklinikum Münster
Camm, A. John
United Kingdom, London
St George’s, University of London
Dorian, Paul
Canada, Toronto
Saint Michael's Hospital University of Toronto
Kowey, Peter R.
United States, Wynnewood
Lankenau Institute for Medical Research
Le-Heuzey, Jean Yves F.
France, Paris
Hôpital Européen Georges-pompidou
Naditch-BrÛlé, Lisa
France, Gentilly
Sanofi S.a.
Prystowsky, Eric N.
United States, Indianapolis
Care Group Llc
Schwartz, Peter J.
Italy, Pavia
Fondazione Irccs Policlinico San Matteo
South Africa, Cape Town
University of Cape Town
Saudi Arabia, Riyadh
King Saud University
Torp-Pedersen, Christian Tobias
Denmark, Copenhagen
Bispebjerg Hospital
Weintraub, William S.
United States, Wilmington
Christiana Care Health System
Crijns, Harry JGM
Netherlands, Maastricht
Universiteit Maastricht
Statistics
Citations: 97
Authors: 12
Affiliations: 13
Identifiers
Doi:
10.1016/j.ahj.2012.02.015
ISSN:
00028703
e-ISSN:
10976744
Research Areas
Health System And Policy
Noncommunicable Diseases
Study Design
Cross Sectional Study
Cohort Study
Case-Control Study
Study Approach
Quantitative