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Low atrial fibrillatory rate is associated with spontaneous conversion of recent-onset atrial fibrillation.

Choudhary, Mariam B; Holmqvist, Fredrik LU ; Carlson, Jonas LU ; Nilsson, Hans-Olof LU ; Roijer, Anders LU and Platonov, Pyotr LU (2013) In Europace 15(10). p.1445-1452
Abstract
AIMS: Atrial fibrillatory rate (AFR) is considered a non-invasive index of atrial remodelling. Low AFR has been associated with favourable outcome of interventions in patients with persistent atrial fibrillation (AF). However, AFR has never been studied in unselected patients with short duration of AF, prone to regain sinus rhythm (SR) spontaneously. The aim of the study was to assess if AFR can predict spontaneous conversion in patients with recent-onset AF.METHODS AND RESULTS: Files of consecutive patients with AF < 48 h seeking emergency room care during a 12-month period were screened (n = 225). Patients with thyroid illness, acute ischaemic heart disease (IHD) or acute congestive heart failure, significant valvular heart disease,... (More)
AIMS: Atrial fibrillatory rate (AFR) is considered a non-invasive index of atrial remodelling. Low AFR has been associated with favourable outcome of interventions in patients with persistent atrial fibrillation (AF). However, AFR has never been studied in unselected patients with short duration of AF, prone to regain sinus rhythm (SR) spontaneously. The aim of the study was to assess if AFR can predict spontaneous conversion in patients with recent-onset AF.METHODS AND RESULTS: Files of consecutive patients with AF < 48 h seeking emergency room care during a 12-month period were screened (n = 225). Patients with thyroid illness, acute ischaemic heart disease (IHD) or acute congestive heart failure, significant valvular heart disease, congenital heart disease, history of cardiac surgery or catheter ablation, or on class I/III antiarrhythmics were excluded. Atrial fibrillatory rate was obtained by QRST cancellation and time frequency analysis of electrocardiogram at admission. The study population comprised 148 patients (age 64 ± 13 years, 52 men), of whom 48 converted to SR within 18 h. Those converting spontaneously comprised more women, had a higher prevalence of first-ever AF episode, IHD, and a lower AFR. The multivariate analysis revealed: AFR < 350 fibrillations per minute [odds ratio (OR) 3.7, 95% confidence interval (CI) 1.3-10.5, P = 0.016], IHD (OR 5.7, 95% CI 1.5-22.4, P = 0.012) and first-ever AF episode (OR 4.1, 95% CI 1.3-13.0, P = 0.015) as independent predictors of spontaneous conversion.CONCLUSION: A low AFR was predictive of spontaneous conversion in patients with recent-onset AF. Along with first-ever AF episode and IHD, AFR can be used in assessing likelihood of spontaneous conversion, if proven in prospective studies. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Europace
volume
15
issue
10
pages
1445 - 1452
publisher
Oxford University Press
external identifiers
  • wos:000325180200011
  • pmid:23515337
  • scopus:84885013167
ISSN
1532-2092
DOI
10.1093/europace/eut057
language
English
LU publication?
yes
id
1de5e71e-7a1a-456b-ba4f-e420cdd384dd (old id 3627864)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/23515337?dopt=Abstract
date added to LUP
2013-04-07 15:31:15
date last changed
2019-03-05 01:32:39
@article{1de5e71e-7a1a-456b-ba4f-e420cdd384dd,
  abstract     = {AIMS: Atrial fibrillatory rate (AFR) is considered a non-invasive index of atrial remodelling. Low AFR has been associated with favourable outcome of interventions in patients with persistent atrial fibrillation (AF). However, AFR has never been studied in unselected patients with short duration of AF, prone to regain sinus rhythm (SR) spontaneously. The aim of the study was to assess if AFR can predict spontaneous conversion in patients with recent-onset AF.METHODS AND RESULTS: Files of consecutive patients with AF &lt; 48 h seeking emergency room care during a 12-month period were screened (n = 225). Patients with thyroid illness, acute ischaemic heart disease (IHD) or acute congestive heart failure, significant valvular heart disease, congenital heart disease, history of cardiac surgery or catheter ablation, or on class I/III antiarrhythmics were excluded. Atrial fibrillatory rate was obtained by QRST cancellation and time frequency analysis of electrocardiogram at admission. The study population comprised 148 patients (age 64 ± 13 years, 52 men), of whom 48 converted to SR within 18 h. Those converting spontaneously comprised more women, had a higher prevalence of first-ever AF episode, IHD, and a lower AFR. The multivariate analysis revealed: AFR &lt; 350 fibrillations per minute [odds ratio (OR) 3.7, 95% confidence interval (CI) 1.3-10.5, P = 0.016], IHD (OR 5.7, 95% CI 1.5-22.4, P = 0.012) and first-ever AF episode (OR 4.1, 95% CI 1.3-13.0, P = 0.015) as independent predictors of spontaneous conversion.CONCLUSION: A low AFR was predictive of spontaneous conversion in patients with recent-onset AF. Along with first-ever AF episode and IHD, AFR can be used in assessing likelihood of spontaneous conversion, if proven in prospective studies.},
  author       = {Choudhary, Mariam B and Holmqvist, Fredrik and Carlson, Jonas and Nilsson, Hans-Olof and Roijer, Anders and Platonov, Pyotr},
  issn         = {1532-2092},
  language     = {eng},
  number       = {10},
  pages        = {1445--1452},
  publisher    = {Oxford University Press},
  series       = {Europace},
  title        = {Low atrial fibrillatory rate is associated with spontaneous conversion of recent-onset atrial fibrillation.},
  url          = {http://dx.doi.org/10.1093/europace/eut057},
  volume       = {15},
  year         = {2013},
}