TY - JOUR
T1 - Progression of atrial fibrillation in the REgistry on Cardiac rhythm disORDers assessing the control of Atrial Fibrillation cohort
T2 - clinical correlates and the effect of rhythm-control therapy
AU - De Vos, Cees B
AU - Breithardt, Günter
AU - Camm, A John
AU - Dorian, Paul
AU - Kowey, Peter R
AU - Le Heuzey, Jean-Yves
AU - Naditch-Brûlé, Lisa
AU - Prystowsky, Eric N
AU - Schwartz, Peter J
AU - Torp-Pedersen, Christian
AU - Weintraub, William S
AU - Crijns, Harry J
N1 - Copyright © 2012 Mosby, Inc. All rights reserved.
PY - 2012/5
Y1 - 2012/5
N2 - 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.
AB - 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.
U2 - 10.1016/j.ahj.2012.02.015
DO - 10.1016/j.ahj.2012.02.015
M3 - Journal article
SN - 0002-8703
VL - 163
SP - 887
EP - 893
JO - American Heart Journal
JF - American Heart Journal
IS - 5
ER -