Progression From Paroxysmal to Persistent Atrial Fibrillation. Clinical Correlates and Prognosis

Cees B. de Vos, Ron Pisters, Robby Nieuwlaat, Martin H. Prins, Robert G. Tieleman, Robert Jan S. Coelen, Antonius C. van den Heijkant, Maurits A. Allessie, Harry J.G.M. Crijns, Dieter Andresen, A. John Camm, Wynn Davies, Alessandro Capucci, Samuel Le´vy, Bertil Olsson, Etienne Aliot, Gu¨nter Breithardt, Stuart Cobbe, Jean Yves Le Heuzey, Massimo SantiniPanos Vardas, Malika Manini, Claire Bramley, Vale´rie Laforest, Charles Taylor, Susan Del Gaiso, Kurt Huber, Guy De Backer, Vera Sirakova, Roman Cerbak, Per Thayssen, Seppo Lehto, Jean Jacques Blanc, Franc¸ois Delahaye, Bondo Kobulia, Uwe Zeymer, Dennis Cokkinos, Kristof Karlocai, Ian Graham, Emer Shelley, Shlomo Behar, Aldo Maggioni, Lino Gonc¸alves, Virginija Grabauskiene, Inger Asmussen, Jaap Deckers, Janina Stepinska, Vyacheslav Mareev, Zorana Vasiljevic, Igor Riecansky, Miran F. Kenda, Angeles Alonso, Jose´ Luis Lopez-Sendon, Annika Rosengren, Peter Buser, Tugrul Okay, Oleg Sychov, Kevin Fox, Peter Schofield, Maarten Simoons, David Wood, Alex Battler, Eric Boersma, Kim Fox, Michel Komajda, Keith McGregor, Barbara Mulder, Sylvia Priori, Lars Ryde´n, Alec Vahanian, William Wijns, Sanofi-Aventis, S. V. Grigoryan, I. Apetyan, S. Aroyan, L. Azarapetyan, Anahit Anvari, Michael Gottsauner-Wolf, Stefan Pfaffenberger, Kadriye Aydinkoc, Karim Kalla, Martina Penka, Heinz Drexel, Peter Langer, Luc A. Pierard, Victor Legrand, Dominique Blommaert, E. Schroeder, Isabelle Mancini, P. Geelen, P. Brugada, Marc De Zutter, Christiaan Vrints, Marc Vercammen, Marielle Morissens, Boyanov Borisov, Valentin Asenov Petrov, Maria Marinova, Alexandrova Assen, Rachev Goudev, Yavor Peychev, Vassil Stoyanovsky, Evgeni Stoynev, Stjepan Kranjcevic, Joseph Moutiris, Marios Ioannides, Dominique Evequoz, Jaroslava Spacilova, Miroslav Novak, Martin Eisenberger, Jolana Mullerova, Josef Kautzner, Lucie Riedlbauchova, Jan Petru`, Milos Taborsky, Helle Cappelen, Yasser A. Sharaf, B. S.S. Ibrahim, Khalid Tammam, Aly Saad, Helmy Elghawaby, Hamed Zaky Sherif, Heba Farouk, Arlett Mielke, Markus Engelen, Paulus Kirchhof, Pia Zimmermann, F. Fernandez Aviles, Jeronimo Rubio, F. Malpartida, M. Corona, Luis Tercedor Sanchez, Jose Miguel, Lozano Herrera, Aurelio Quesada, Antonio J.Munoz Garcia, Carlos Sanchez Gonzalez, M. Soledad Alcasena Juango, Jesus Berjon-Reyero, Josep M. Alegret, J. M.Cruz Fernandez, Cesar Carrascosa, Rosillo Antonio Fernandez Romero, Miguel Gonza´lez Lara, Jose´ L.Lopez Sendon, Jose´ Juan Gomez de Diego, Luis Sosa Martin, Maria Irurita, Norbero Herrera Guttierez, Juan Ramon Siles Rubio, Isabel Antorrena, Alicia Bautista Paves, Antonio Salvador, Maria Dolores Orriach, A. Alonso Garcia, Francisco Epelde, Vicente Bertomeu Martinez, Antonio Berruezo Sanchez, Carlos Pinero Galvez, Rafael Fernandez Rivero, Antonio Hernandez Madrid, Gonzalo Baron-Esquivias, Rafael Peinado, Jose´ Antonio Gomez Guindal, Tomas Ripoll Vera, Emilio Luengo Fernandez, Ricardo Gayan, Javier Garcia, Andres Bodegas, Jesus Toril Lopez, Julio Martinez Florez, Cristobal Lozano Cabezas, Eduardo Vazquez Ruiz de Castroviejo, Juan Munoz Bellido, Maria Eugenia Ruiz, Kirsti Savolainen, Markku Nieminen, Lauri Toivonen, Mikko Syvanne, Mervi Pietila, Daniel Galley, Christine Beltra, Alain Gay, J. C. Daubert, Guillaume Lecocq, Christine Poulain, J. G.F.C. Cleland, Rhidian Shelton, A. Choudhury, Gulnara Abuladze, Irina Jashi, Anastasia Tsiavou, G. Giamouzis, N. Dagres, A. Kostopoulou, Domproglou Tsoutsanis, C. Stefanadis, George Latsios, Ioannis Vogiatzis, Alexandros Gotsis, Paraskevi Bozia, Maria Karakiriou, Spyridon Koulouris, John Parissis, George Kostakis, Nikos Kouris, Dimitra Kontogianni, Koutroubas Athanasios, Alexandros Douras, Themistoklis Tsanakis, Mary Marketou, Nikolaos Patsourakos, Laszlo Czopf, Robert Halmosi, Istvan Pre´da, Eva Csoti, Andrea Badics, Boris Strasberg, Nahum A. Freedberg, Amos Katz, Eli Zalzstein, Aviva Grosbard, E. Goldhammer, Menachem Nahir, Menashe Epstein, Ida Vider, David Luria, Lori Mandelzweig, Bruno Aloisi, Alfio Cavallaro, Emanuele Antonielli, Baldassarre Doronzo, Diego Pancaldo, Carlo Mazzola, Liliana Buontempi, Valeria Calvi, Giuseppe Giuffrida, Antonino Figlia, Francesco Ippolito, Gian Paolo Gelmini, N. Gaibazzi, Virgilio Ziacchi, Francesco De Tommasi, Federico Lombardi, Cesare Fiorentini, Paolo Terranova, Pietro Maiolino, Muhamad Albunni, Plinio Pinna-Pintor, Stefano Fumagalli, Guilio Masotti, Lorenzo Boncinelli, Domenico Rossi, Giovanni Maria Santoro, Massimo Fioranelli, Franco Naccarella, Stefano Sdringola Maranga, Giovannina Lepera, Barbara Bresciani, Elena Seragnoli, Mara Cantelli Forti, Valentina Cortina, Giacinto Baciarello, Paolo Cicconetti, Antonio Lax, Federica Vitali, Diran Igidbashian, Luisa Scarpino, Sergio Terrazzino, Luigi Tavazzi, Francesco Cantu, Francesco Pentimalli, Salvatore Novo, Giuseppe Coppola, Gianluca Zingarini, Giuseppe Ambrozio, Paolo Moruzzi, Sergio Callegari, Gabriele Saccomanno, Paolo Russo, Emanuele Carbonieri, Anna Paino, Marco Zanetta, Enzo Barducci, Roberto Cemin, Werner Rauhe, Walter Pitscheider, Marina Meloni, Sergio Mariano Marchi, Marco Di Gennaro, Sergio Calcagno, Paola Squaratti, Francesco Quartili, Patrizia Bertocchi, Mario De Martini, Giuseppe Mantovani, Roman Komorovsky, Alessandro Desideri, Leopoldo Celegon, Luigi Tarantini, Giuseppe Catania, Donata Lucci, Francesca Bianchini, Aras Puodziukynas, Ausra Kavoliuniene, Vilija Barauskiene, Audrius Aidietis, Jurate Barysiene, Vitas Vysniauskas, Irena Zukauskiene, Nijole Kazakeviciene, Ljubica Georgievska-Ismail, Lidija Poposka, Eleonora Vataman, Aurel A. Grosu, Wilma Scholte op Reimer, Esther de Swart, Mattie Lenzen, Chris Jansen, Ritzo Brons, Henriette Tebbe, D. C.A. van Hoogenhuyze, M. J. Veerhoek, Maria Kamps, D. Haan, Nitolanda van Rijn, Annette Bootsma, Leo Baur, Adrie van den, Heidi Fransen, Luc Eurlings, Joan Meeder, M. J. De Boer, Jobst Winter, Herman Broers, Chris Werter, M. Bijl, Saskia Versluis, Malgorzata Milkowska, Beata Wozakowska-Kaplon, Marianna Janion, Lidia Lepska, Grazyna Swiatecka, Piotr Kokowicz, Jacek Cybulski, Aleksandr Gorecki, Marcin Szulc, Jerzy Rekosz, Rafal Manczak, Anna Maria Wnuk-Wojnar, M. Trusz-Gluza, Anna Rybicka-Musialik, Jaroslaw Myszor, Michal Szpajer, Krzysztof Cymerman, Jerzy Sadowski, Maria Sniezek-Maciejewska, Mariola Ciesla-Dul, Izabela Gorkiewicz-Kot, Tomasz Grodzicki, Krzysztof Rewiuk, Leszek Kubik, Jacek Lewit, Joao Manuel Frazao Rodrigues de Sousa, Rafael Ferreira, Antonio Freitas, Joao Carlos Araujo Morais, Rui Pires, M. J.Veloso Gomes, Paula Gago, Rui Alexandre C. Candeias, Luis Nunes, Joao Vitor Miranda Sa, Miguel Ventura, Mario de Oliveira, Luis Brandao Alves, Ioan Bostaca, Codin T. Olariu, G. A. Dan, Anca Dan, Cristian Podoleanu, Attila Frigy, George I.M. Georgescu, Catalina Arsenescu, Cristian Statescu, Radu Sascau, Dan L. Dimitrascu, Raluca Rancea, Yuri V. Shubik, Dmitry Duplyakov, Marina Shalak, Marine Danielyan, Albert Galyavich, Venera Zakirova, Robert Hatala, Gabriela Kaliska, Jan Kmec, Igor Zupan, Jerneja Tasie`, Damijan Vokac, Nils Edvardsson, Dritan Poci, Habib Gamra, Hichem Denguir, Ahmet Sepetoglu, Alev Arat-Ozkan, Mariya Orynchak, Elena Paliy, I. Vakalyuk, David Malidze, Rostyslav Prog, Myckola Ivanovich Yabluchansky, Nataliya Volodimirovna Makienko, Tatjana Potpara, Sofija Knezevic, Miomir Randjelovic

Research output: Contribution to journalArticlepeer-review

Abstract

Objectives: We investigated clinical correlates of atrial fibrillation (AF) progression and evaluated the prognosis of patients demonstrating AF progression in a large population. Background: Progression of paroxysmal AF to more sustained forms is frequently seen. However, not all patients will progress to persistent AF. Methods: We included 1,219 patients with paroxysmal AF who participated in the Euro Heart Survey on AF and had a known rhythm status at follow-up. Patients who experienced AF progression after 1 year of follow-up were identified. Results: Progression of AF occurred in 178 (15%) patients. Multivariate analysis showed that heart failure, age, previous transient ischemic attack or stroke, chronic obstructive pulmonary disease, and hypertension were the only independent predictors of AF progression. Using the regression coefficient as a benchmark, we calculated the HATCH score. Nearly 50% of the patients with a HATCH score >5 progressed to persistent AF compared with only 6% of the patients with a HATCH score of 0. During follow-up, patients with AF progression were more often admitted to the hospital and had more major adverse cardiovascular events. Conclusions: A substantial number of patients progress to sustained AF within 1 year. The clinical outcome of these patients regarding hospital admissions and major adverse cardiovascular events was worse compared with patients demonstrating no AF progression. Factors known to cause atrial structural remodeling (age and underlying heart disease) were independent predictors of AF progression. The HATCH score may help to identify patients who are likely to progress to sustained forms of AF in the near future.

Original languageEnglish
Pages (from-to)725-731
Number of pages7
JournalJournal of the American College of Cardiology
Volume55
Issue number8
DOIs
StatePublished - 23 Feb 2010

Keywords

  • atrial fibrillation
  • epidemiology
  • prediction
  • prognosis
  • progression

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