Aims: Clinicians increasingly encounter patients with young-onset atrial fibrillation (AF). Aim is to study clinical profile, AF progression, and outcome of patients with young-onset AF. Methods and results: A total of 468 patients with paroxysmal or persistent AF starting <60 years of age were included. Clinical profile, AF progression, defined as development of permanent AF, and cardiovascular events were prospectively collected. Onset of AF was at 46 ± 10 years, 354 (76%) were men, 329 (70%) had paroxysmal AF, 50 (11%) had AF without risk factors or comorbidities, and 118 (25%) had familial AF. Hypertension was present in 207 (44%), heart failure in 44 (9%). During 7.2 (2.7-10.0) years, 56 (11%) had AF progression (2.0%/year). Progression rate in patients receiving antiarrhythmic drugs or pulmonary vein isolation during follow-up was not different from patients who did not. Multivariable determinants of AF progression included diastolic blood pressure [hazard ratio (HR) 1.031, 95% confidence interval (95% CI) 1.007-1.055; P = 0.010] and left atrial size (HR 1.055, 95% CI 1.012-1.099; P = 0.012). Cardiovascular events occurred in 61 patients (13%; 2.4%/year). Multivariable determinants of cardiovascular events were PR interval (HR 1.015, 95% CI 1.005-1.024; P = 0.002) and left ventricular hypertrophy (HR 3.429, 95% CI 1.712-6.868; P = 0.001). Yearly event rate was higher in patients who had developed AF progression, compared to patients without progression [4.9 (2.3-9.0)% vs. 1.9 (1.4-2.6)%; P = 0.006]. Conclusion: Nine of 10 patients with young-onset AF had risk factors and comorbidities, 25% had familial AF. Atrial fibrillation progression to permanent AF and cardiovascular events occurred in 2.0% and 2.4% per year, respectively. Cardiovascular events increased after AF progression had occurred.
Aims: Clinicians increasingly encounter patients with young-onset atrial fibrillation (AF). Aim is to study clinical profile, AF progression, and outcome of patients with young-onset AF. Methods and results: A total of 468 patients with paroxysmal or persistent AF starting <60 years of age were included. Clinical profile, AF progression, defined as development of permanent AF, and cardiovascular events were prospectively collected. Onset of AF was at 46 ± 10 years, 354 (76%) were men, 329 (70%) had paroxysmal AF, 50 (11%) had AF without risk factors or comorbidities, and 118 (25%) had familial AF. Hypertension was present in 207 (44%), heart failure in 44 (9%). During 7.2 (2.7-10.0) years, 56 (11%) had AF progression (2.0%/year). Progression rate in patients receiving antiarrhythmic drugs or pulmonary vein isolation during follow-up was not different from patients who did not. Multivariable determinants of AF progression included diastolic blood pressure [hazard ratio (HR) 1.031, 95% confidence interval (95% CI) 1.007-1.055; P = 0.010] and left atrial size (HR 1.055, 95% CI 1.012-1.099; P = 0.012). Cardiovascular events occurred in 61 patients (13%; 2.4%/year). Multivariable determinants of cardiovascular events were PR interval (HR 1.015, 95% CI 1.005-1.024; P = 0.002) and left ventricular hypertrophy (HR 3.429, 95% CI 1.712-6.868; P = 0.001). Yearly event rate was higher in patients who had developed AF progression, compared to patients without progression [4.9 (2.3-9.0)% vs. 1.9 (1.4-2.6)%; P = 0.006]. Conclusion: Nine of 10 patients with young-onset AF had risk factors and comorbidities, 25% had familial AF. Atrial fibrillation progression to permanent AF and cardiovascular events occurred in 2.0% and 2.4% per year, respectively. Cardiovascular events increased after AF progression had occurred.
Authors: Mariëlle Kloosterman; Jonas Oldgren; David Conen; Jorge A Wong; Stuart J Connolly; Alvaro Avezum; Salim Yusuf; Michael D Ezekowitz; Lars Wallentin; Marie Ntep-Gweth; Philip Joseph; Tyler W Barrett; Supachai Tanosmsup; William F McIntyre; Shun Fu Lee; Ratika Parkash; Guy Amit; Alex Grinvalds; Isabelle C Van Gelder; Jeff S Healey Journal: Europace Date: 2020-06-01 Impact factor: 5.214
Authors: Ruben R De With; Ömer Erküner; Michiel Rienstra; Bao-Oanh Nguyen; Frank W J Körver; Dominik Linz; Hugo Cate Ten; Henri Spronk; Abraham A Kroon; Alexander H Maass; Yuri Blaauw; Robert G Tieleman; Martin E W Hemels; Joris R de Groot; Arif Elvan; Mirko de Melis; Coert O S Scheerder; Meelad I H Al-Jazairi; Ulrich Schotten; Justin G L M Luermans; Harry J G M Crijns; Isabelle C Van Gelder Journal: Europace Date: 2020-08-01 Impact factor: 5.214
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