Incidence and Predictors of Atrial Fibrillation Progression

Steffen Blum, Stefanie Aeschbacher, Pascal Meyre, Leon Zwimpfer, Tobias Reichlin, Jurg H. Beer, Peter Ammann, Angelo Auricchio, Richard Kobza, Paul Erne, Giorgio Moschovitis, Marcello Di Valentino, Dipen Shah, Jurg Schlapfer, Selina Henz, Christine Meyer-Zurn, Laurent Roten, Matthias Schwenkglenks, Christian Sticherling, Michael KuhneStefan Osswald, David Conen, Leo Bonati, Lorin Frohlich, Rebecca Gugganig, Thomas Kofler, Philipp Krisai, Andreas U. Monsch, Christian Mueller, Christiane Pudenz, Philipp Reddiess, Javier Ruperti Repilado, Aleksandra Schweizer, Anne Springer, Fabienne Steiner, Samuel Stempfel, Thomas Szucs, Jan van der Stouwe, Gian Voellmin, Drahomir Aujesky, Urs Fischer, Juerg Fuhrer, Simon Jung, Heinrich Mattle, Luise Adam, Carole Elodie Aubert, Martin Feller, Claudio Schneider, Axel Loewe, Elisavet Moutzouri, Tanja Fluckiger, Cindy Groen, Nathalie Schwab, Nicolas Rodondi, Christopher Beynon, Roger Dillier, Franz Eberli, Simone Fontana, Christine Franzini, Isabel Juchli, Claudia Liedtke, Jacqueline Nadler, Thayze Obst, Noreen Tynan, Xiaoye Schneider, Katrin Studerus, Dominik Weishaupt, Andreas Mueller, Silke Kuest, Karin Scheuch, Denise Hischier, Nicole Bonetti, Corina Bello, Henriette Isberg, Alexandra Grau, Jonas Villinger, Mary-Monica Papaux, Eva Laube, Philipp Baumgartner, Mark Filipovic, Marcel Frick, Stefanie Leuenberger, Adriana Anesini, Cristina Camporini, Giulio Conte, Maria Luce Caputo, Francois Regoli, Tiziano Moccetti, Roman Brenner, David Altmann, Manuela Forrer, Michaela Gemperle, Mathieu Firmann, Sandrine Foucras, Daniel Hayoz, Benjamin Berte, Andrea Kaeppeli, Myriam Roth, Brigitta Mehmann, Markus Pfeiffer, Ian Russi, Kai Schmidt, Vanessa Weberndoerfer, Mabelle Young, Melanie Zbinden, Luisa Vicari, Jane Frangi-Kultalahti, Tatiana Terrot, Giorgio Moschovitis, Georg Ehret, Herve Gallet, Elise Guillermet, Francois Lazeyras, Karl-Olof Lovblad, Patrick Perret, Cheryl Teres, Nathalie Lauriers, Marie Mean, Nisha Arenja, Andrea Gret, Sandra Vitelli, Jan Novak, Jane Frangi, Augusto Gallino, Renate Schoenenberger-Berzins, Fabienne Witassek, Christoph Stippich, Ernst-Wilhelm Radue, Tim Sinnecker, Jens Wurfel, Pascal Benkert, Thomas Fabbro, Patrick Simon, Michael Coslovsky, Ramun Schmid

Research output: Other contribution

51 Citations (Scopus)

Abstract

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.
Original languageEnglish
Number of pages1
Edition20
Volume8
DOIs
Publication statusPublished - 15 Oct 2019

Keywords

  • atrial fibrillation
  • epidemiology
  • predictors
  • progression
  • rhythm control

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