Prediction of Transition to Chronic Atrial Fibrillation in Patients With Paroxysmal Atrial Fibrillation by Signal- Averaged Electrocardiography

Abe, Yasushi; Fukunami, Masatake; Yamada, Takahisa; Ohmori, Masanobu; Shimonagata, Tsuyoshi; Kumagai, Kazuaki; Kim, Jiyoong; Shoji, Shuichi; Hori, Masatsugu; Hoki, Noritake

doi:10.1161/01.cir.96.8.2612

Cited by 106 publications

(95 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Enlarged left atrial dimension was identified as a predictor of transition to persistent AF, as previously reported by Abe et al 13 Stretching of myocardial cells due to atrial dilatation may induce changes in electrical properties of atrial fibers that favor dispersion of refractoriness and disordered electrical activation and contribute to the persistence of AF. 19 Left atrial dimension was significantly greater in the group that did than in the group that did not develop persistent AF, but there were no significant differences between the two groups with respect to P-terminal force, an ECG indicator widely used for detecting left atrial dimension enlargement.…”

Section: Left Atrial Dimension On Ultrasonic Echocardiographysupporting

confidence: 73%

“…8,10,11 The ability to predict progression from paroxysmal to persistent AF is therefore also important clinically. Previous studies have identified disease duration, 4 left ventricular dysfunction, 12 enlarged left atrial dimension, 13 advanced age, 14 prolongation of FPD, 13 and a low root mean square voltage for the last 30 ms of the filtered P wave 13 as indicators of transition from paroxysmal to persistent AF. How-72 Abbreviations: ECG = electrocardiogram, P-SAECG = P-wavetriggered signal-averaged electrocardiogram, FPD = filtered P-wave duration, RMS30 = root mean square voltage for the last 30 ms of filtered P-wave, Echo = echocardiogram, LAD = left atrial dimension, LVDd = left ventricular end-diastolic dimension, LVEF = left ventricular ejection fraction.…”

Section: Discussion Prediction Of Transition To Persistent Atrial Fibmentioning

confidence: 99%

See 1 more Smart Citation

Investigation of the predictors of transition to persistent atrial fibrillation in patients with paroxysmal atrial fibrillation

Koide

Yotsukura

Sakata

et al. 2002

Clinical Cardiology

View full text Add to dashboard Cite

SummaryBackground: Until now, no clinically useful indicators have existed that predict the transition from paroxysmal to persistent atrial fibrillation (AF).Hypothesis: The current prospective study was conducted for identifying predictors of progression to persistent AF over the long term.Methods: We studied 102 consecutive patients (mean age: 55 ± 10 years; 75 men and 27 women) diagnosed with paroxysmal AF. Standard 12-lead electrocardiography, echocardiography, and P-wave-triggered signal-averaged electrocardiography (P-SAECG) were performed on all patients at the time of their entry into the study.Results: The mean follow-up period was 61 ± 13 months. Group 1 (n = 66) comprised patients in whom paroxysmal AF did not progress to persistent AF, and Group 2 (n = 36) comprised those who developed persistent AF. In Group 2 the patients were significantly older, and P-wave dispersion, filtered P-wave duration (FPD), and left atrial dimension were significantly higher than in Group 1 (p < 0.05). The root mean square voltage for the last 30 ms of the filtered P-wave was also significantly lower in Group 2 (p < 0.05). Multivariate logistic regression analysis using these five factors identified left atrial dimension (odds ratio [OR] 2.29; 95% confidence interval [CI] 1.16-4.54; p = 0.02) and FPD (OR 2.71; 95% CI 1.78-4.13; p<0.01) as independent predictors of transition to persistent AF. Left atrial dimension ≥ 40 mm predicted progression

show abstract

Section: Left Atrial Dimension On Ultrasonic Echocardiographysupporting

confidence: 73%

Section: Discussion Prediction Of Transition To Persistent Atrial Fibmentioning

confidence: 99%

Investigation of the predictors of transition to persistent atrial fibrillation in patients with paroxysmal atrial fibrillation

Koide

Yotsukura

Sakata

et al. 2002

Clinical Cardiology

View full text Add to dashboard Cite

show abstract

“…4) Factors related to the development of permanent AF have been reported. 2,[5][6][7] A number of recent studies 3,[8][9][10][11] have associated AF and its treatment with quality-of-life issues.…”

Section: Discussionmentioning

confidence: 99%

Symptoms of Atrial Fibrillation in Patients With and Without Subsequent Permanent Atrial Fibrillation Based on a Retrospective Questionnaire Survey

Kawara¹,

Narumi

Hirao

et al. 2010

Int. Heart J.

View full text Add to dashboard Cite

SummaryThe aim of the present study was to determine whether symptoms of atrial fibrillation (AF) differ between patients with and without subsequent permanent AF. Sixty-four patients (68 ± 10 years old, 45 males) were recruited. AF followup was started at the age of 61 ± 10 years and accomplished in a median period of 4.9 years (396 person-years). Permanent AF, defined as lasting > 180 days, developed in 17 patients (14 males) (43 per 1000 person-years). The AF followup period was longer in the permanent AF group than in the non-permanent AF group (median, 9.8 versus 4.2 years, P < 0.001). For baseline characteristics, hypertension was less frequent in the permanent AF group than in the nonpermanent AF group (18% versus 45%, P < 0.05). A retrospective questionnaire survey regarding initial AF symptoms was conducted. The severity of AF symptoms by a 4-grade scale was significantly milder in the permanent AF group than in the nonpermanent AF group (P < 0.05). Cox proportional hazards model analysis revealed that the severity of initial AF symptoms was related to the subsequent development of permanent AF (hazard ratio 0.46 per grade, 95% confidence interval 0.23 -0.93, P < 0.05), but age, gender, hypertension, diabetes mellitus, organic heart disease, and left atrial dimension were not. The permanent AF-free rate was significantly lower in 33 patients with mild symptoms than in 31 patients with severe symptoms (log-rank test, P < 0.05). These results point to an inconspicuous feature in the development of permanent AF. (Int Heart J 2010; 51: 242-246) Key words: Arrhythmia, Heart failure, Hypertension, Susceptibility T he severity of symptoms is quite an important factor for determining the prognosis of patients with organic heart disease. The New York Heart Association classification of cardiac performance is clearly related to subsequent cardiac events. Syncope is a risk factor for sudden cardiac death in patients with a Brugada-type electrocardiogram. As a consequence, symptoms affect the treatment of such diseases. Atrial fibrillation (AF) causes variable symptoms, from mild which are subclinical, to severe requiring emergency care. Very slightly symptomatic AF is allowed and left; by contrast, severely symptomatic AF requires intensive therapies to restore or maintain sinus rhythm. AF usually occurs in a paroxysmal or persistent form, and then develops into a permanent form when the feasibility of restoring sinus rhythm becomes extremely low.1,2) We believe that patients' perceptions of their symptoms may be associated with the course of AF. To clarify whether the symptoms of AF differ between patients with and without subsequent development of permanent AF, a retrospective questionnaire survey was carried out. MethodsEthical issues: The study was conducted in accordance with Good Clinical Practice guidelines and the Declaration of Helsinki. The study protocol and written subject information were reviewed and approved by the ethics committee of Tokyo Medical and Dental University. Sixty-four patients (68 ±...

show abstract

“…In this context, P-wave signalaveraged electrocardiography proved to be a noninvasive, low-cost, easily performed and reproducible method; therefore, it has been widely used in the evaluation and stratification of the risk of atrial fibrillation [16][17][18][19][20][21][22][23][24][25][26][27] .…”

Section: Discussionmentioning

confidence: 99%

Atrial activation during sinus rhythm in patients with rheumatic and non-rheumatic paroxysmal atrial fibrillation. Frequency-domain analysis using signal-averaged electrocardiography

Dantas¹,

Barbosa²,

Benchimol-Barbosa³

et al. 2001

Arq. Bras. Cardiol.

View full text Add to dashboard Cite

Objective -Using P-wave signal-averaged electrocardiography, we assessed the patterns of atrial electrical activation in patients with idiopathic atrial fibrillation as compared with patterns in patients with atrial fibrillation associated with structural heart disease. Atrial fibrillation is the most common sustained arrhythmia diagnosed in clinical practice [1][2][3][4] . In the general population, its prevalence increases with age: it is lower than 1% in the age bracket from 40 to 65 years, ranges from 2% to 5% in the age bracket from 65 to 74 years, and is higher than 5% above the age of 75 years. No difference in incidence has been observed between the sexes 1 . The increase in prevalence and incidence of atrial fibrillation with age is mainly associated with coexisting cardiac diseases. However, an independent effect of direct ageing on the atrial tissue cannot be excluded 5 . Methods -Eighty patients with recurrent paroxysmalA history of congestive heart failure, rheumatic valvar disease, left ventricular hypertrophy, and left atrial enlargement are independent risk factors associated with the genesis of atrial fibrillation. The presence of this arrhythmia in structurally normal hearts, although infrequent, may be detected in clinical practice. The triggering and maintenance factors of idiopathic atrial fibrillation are not very well defined. However, a significant number of patients with the paroxysmal or persistent form of atrial fibrillation, even though without evidence of anatomical cardiac alterations, evolve towards chronic atrial fibrillation. Such patients include those with structural heart disease despite the use of antiarrhythmic drugs. The objective of our study was to identify the electrophysiological behavior of atrial activation in patients with paroxysmal or persistent atrial fibrillation, through the use of P-wave signal-averaged electrocardiography for frequency-domain analysis. MethodsIn a cross-sectional study, we analyzed 80 patients who were being followed up in the outpatient cardiac arrhythmia care unit of the Hospital Universitário Pedro Ernesto. These patients had a history of at least 2 episodes of paroxysmal or persistent atrial fibrillation confirmed on electrocardiography in the last year, and they had not used any antiarrhythmic drug for at least 5 half-lives of each drug in

show abstract

Prediction of Transition to Chronic Atrial Fibrillation in Patients With Paroxysmal Atrial Fibrillation by Signal- Averaged Electrocardiography

Abstract: These results indicate that P-SAE could be useful to identify patients at risk for the transition from PAF to CAF.

Cited by 106 publications

References 16 publications

Investigation of the predictors of transition to persistent atrial fibrillation in patients with paroxysmal atrial fibrillation

Investigation of the predictors of transition to persistent atrial fibrillation in patients with paroxysmal atrial fibrillation

Symptoms of Atrial Fibrillation in Patients With and Without Subsequent Permanent Atrial Fibrillation Based on a Retrospective Questionnaire Survey

Atrial activation during sinus rhythm in patients with rheumatic and non-rheumatic paroxysmal atrial fibrillation. Frequency-domain analysis using signal-averaged electrocardiography

Contact Info

Product

Resources

About