ArticleJournal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing2015
The natural history of atrial fibrillation in patients with permanent pacemakers: is atrial fibrillation a progressive disease?
Article in Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 5 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
15 citing papers in PubMed, 5 syntheses or guidelines pooled it, 31 citations in OpenAlex.
- 2023 ACC/AHA/ACCP/HRS Guideline for the Diagnosis and Management of Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines.Journal of the American College of Cardiology · 2024Guideline
- Guideline
- Hybrid ablation versus transcatheter ablation for atrial fibrillation: A meta-analysis.Medicine · 2019Pooled it
- 2017 HRS/EHRA/ECAS/APHRS/SOLAECE expert consensus statement on catheter and surgical ablation of atrial fibrillation.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2018Guideline
- Guideline
- IiScience · 2022Article
- The Role of Epicardial Adipose Tissue in the Development of Atrial Fibrillation, Coronary Artery Disease and Chronic Heart Failure in the Context of Obesity and Type 2 Diabetes Mellitus: A Narrative Review.Journal of cardiovascular development and disease · 2022Review
- Interrupting the Natural History of Atrial Fibrillation. Image from the Future.Journal of atrial fibrillation · 2018Article
- Atrial fibrillation variability on long-term monitoring of implantable cardiac rhythm management devices.Clinical cardiology · 2017Observational
- 2017 HRS/EHRA/ECAS/APHRS/SOLAECE expert consensus statement on catheter and surgical ablation of atrial fibrillation.Heart rhythm · 2017Article
- Atrial Fibrillation: Epidemiology, Pathophysiology, and Clinical Outcomes.Circulation research · 2017Review
- Recent advances in rhythm control for atrial fibrillation.F1000Research · 2017Review
- Myocardial architecture and patient variability in clinical patterns of atrial fibrillation.Physical review. E · 2016Article
- A Stochastic Individual-Based Model of the Progression of Atrial Fibrillation in Individuals and Populations.PloS one · 2016Article
- Understanding the transition from paroxysmal to persistent atrial fibrillation.Physical review researchArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesAtrial fibrillation (AF) is thought to be a progressive arrhythmia, starting with short paroxysmal episodes, until eventually, it becomes permanent. Evidence for this is limited to studies with short follow-up or with minimal cardiac rhythm monitoring. We utilised the continuous rhythm monitoring capabilities of implanted pacemakers to define better the natural history of AF.
methodsThe study included 356 patients with pacemaker devices capable of continuous atrial rhythm monitoring (186 male, mean age (± SD) 79.5 ± 8.9 years). All clinical records, including history/physical examination reports, laboratory results, ECGs and Holter monitoring data were reviewed. Patients were included if AF episodes >30 s were documented. Permanent pacemaker diagnostic data were reviewed at least every 12 months. ACC/AHA/ESC guidelines were used to define AF episodes as paroxysmal, persistent or long-standing persistent/permanent.
resultsStudy follow-up period (± SD) was 7.2 ± 3.1 years. Over the study period, 179 of 356 patients (50.3 %) had at least one episode of persistent AF. Of the 356 patients, 314 (88.2 %) had paroxysmal AF and 42 (11.8 %) had persistent AF at the time of diagnosis. The predominant AF subtype, at latest follow-up, was paroxysmal for 192 patients (53.9 %), persistent for 77 (21.6 %) and long-standing persistent/permanent for 87 (24.4 %). Univariable predictors of progression to persistent AF were (1) male gender, (2) increasing left atrial diameter (LAD), (3) reduced atrial pacing (AP) and (4) increasing ventricular pacing.
conclusionsAlthough many patients with AF will have persistent episodes, long-term continuous pacemaker follow-up demonstrates that the majority will have a paroxysmal, as opposed to persistent, form of the arrhythmia.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.