Progression of Paroxysmal to Persistent Atrial Fibrillation

Jahangir, Arshad; Murarka, Shishir

doi:10.1016/j.jacc.2009.12.010

Cited by 17 publications

(16 citation statements)

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“…A score of 2-4 points was considered to indicate moderate risk, and a HATCH score of five or more points was considered to indicate high risk for the development of persistent AF [6]. The HATCH score was also investigated in other studies for progression of paroxysmal to persistent AF and was found to be useful in the study carried out by Jahangir and Murarka [20] and modestly useful in studies performed by Potpara et al [21] and Barret et al [22]. The HATCH score was also evaluated for predicting the recurrence of AF after catheter ablation in studies carried out by Tang et al [23], in which the score proved not to be useful.…”

Section: Discussionmentioning

confidence: 99%

The role of HATCH score in predicting the success rate of sinus rhythm following electrical cardioversion of atrial fibrillation

et al. 2016

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A b s t r a c t Background:The HATCH score predicts the development of persistent and permanent atrial fibrillation (AF) one year after spontaneous or pharmacological conversion to sinus rhythm in patients with AF. However, it remains unknown whether HATCH score predicts short-term success of the procedure at early stages for patients who have undergone electrical cardioversion (EC) for AF. Aim:The present study evaluated whether HATCH score predicts short-term success of EC in patients with AF. Methods:The study included patients aged 18 years and over, who had undergone EC due to AF lasting less than 12 months, between December 2011 and October 2013. HATCH score was calculated for all patients. The acronym HATCH stands for Hypertension, Age (above 75 years), Transient ischaemic attack or stroke, Chronic obstructive pulmonary disease, and Heart failure. This scoring system awards two points for heart failure and transient ischaemic attack or stroke and one point for the remaining items. Results:The study included 227 patients and short-term EC was successful in 163 of the cases. The mean HATCH scores of the patients who had undergone successful or unsuccessful EC were 1.3 ± 1.4 and 2.9 ± 1.4, respectively (p < 0.001). The area of the HATCH score under the curve in receiver operating characteristics analysis was (AUC) 0.792 (95% CI 0.727-0.857, p < 0.001). A HATCH score of two and above yielded 77% sensitivity, 62% specificity, 56% positive predictive value, and 87% negative predictive value in predicting unsuccessful cardioversion.Conclusions: HATCH score is useful in predicting short-term success of EC at early stages for patients with AF, for whom the use of a rhythm-control strategy is planned.

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Section: Discussionmentioning

confidence: 99%

The role of HATCH score in predicting the success rate of sinus rhythm following electrical cardioversion of atrial fibrillation

et al. 2016

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“…7 Due to the impact of PoAF on intensive care and hospital stays, 7 health care costs, and patient morbidity and mortality, 4,10–13 it is critical that we improve our ability to identify patients at high risk for developing PoAF for improved selection of prophylactic interventions, closer monitoring for postoperative complications, and establishing the risk of long-term AF. 1,7,31,32,34 Although several circulatory biomarkers have been proposed to stratify patients with a history of AF or at risk of AF and its complications, the existing data are conflicting (Table 1). Markers of active collagen synthesis (elevated PICP and PIIINP), ECM remodeling (elevated MMP-9), myocardial stretch (BNP, NTpro-BNP), inflammation ( RANKL, IL-6) and profibrotic mediators (TGF-β1) appear to be promising in identifying those at risk for the development of PoAF (Table 2).…”

Section: Discussionmentioning

confidence: 99%

Circulating Biomarkers Predictive of Postoperative Atrial Fibrillation

Turagam

Mirza

Werner

et al. 2016

Cardiology in Review

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Postoperative atrial fibrillation (PoAF), a common complication of cardiac surgery, contributes significantly to morbidity, mortality, and increasing health care costs. Despite advances in surgical and medical management, the overall incidence of PoAF has not changed significantly, partly due to the limited understanding of mechanisms underlying acute surgery-related factors, such as myocardial injury, inflammation, sympathetic activation, and oxidative stress, which play an important role in the initiation of PoAF, while a preexisting atrial substrate appears to be more important in the maintenance of this dysrhythmia. Thus, in a majority of patients, PoAF becomes a manifestation of an underlying arrhythmogenic substrate that is unmasked following acute surgical stress. As such, the ability to identify which patients have this proarrhythmic substrate and are, therefore, at high risk for developing AF postoperatively, is important for the improved selection for prophylactic interventions, closer monitoring for complications, and establishing the probability of AF in the long term. This review highlights the role of the underlying substrate in promoting PoAF, proposed mechanisms, and the potential role of serum biomarkers to identify patients at risk for PoAF.

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“…A heterogeneous condition with variable etiology, natural history and prognosis [19,33], AF progresses with time in most patients, where infrequent self-terminating episodes that respond to rhythm controlling medication become more frequently sustained, with symptoms refractory to treatment, ultimately progressing to the permanent form [34-36]. In our study, patients with frequent PLMS were more likely to progress to require additional antiarrhythmic therapy for symptomatic recurrences or to permanent AF than those with infrequent PLMS.…”

Section: Discussionmentioning

confidence: 99%

Frequent Periodic Leg Movement During Sleep Is an Unrecognized Risk Factor for Progression of Atrial Fibrillation

et al. 2013

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Sleep apnea has been recognized as a factor predisposing to atrial fibrillation recurrence and progression. The effect of other sleep-disturbing conditions on atrial fibrillation progression is not known. We sought to determine whether frequent periodic leg movement during sleep is a risk factor for progression of atrial fibrillation. In this retrospective study, patients with atrial fibrillation and a clinical suspicion of restless legs syndrome who were referred for polysomnography were divided into two groups based on severity of periodic leg movement during sleep: frequent (periodic movement index >35/h) and infrequent (≤35/h). Progression of atrial fibrillation to persistent or permanent forms between the two groups was compared using Wilcoxon rank-sum test, chi-square tests and logistic regression analysis. Of 373 patients with atrial fibrillation (77% paroxysmal, 23% persistent), 108 (29%) progressed to persistent or permanent atrial fibrillation during follow-up (median, 33 months; interquartile range, 16-50). Compared to patients with infrequent periodic leg movement during sleep (n=168), patients with frequent periodic leg movement during sleep (n=205) had a higher rate of atrial fibrillation progression (23% vs. 34%; p=0.01). Patients with frequent periodic leg movement during sleep were older and predominantly male; however, there were no significant differences at baseline in clinical factors that promote atrial fibrillation progression between both groups. On multivariate analysis, independent predictors of atrial fibrillation progression were persistent atrial fibrillation at baseline, female gender, hypertension and frequent periodic leg movement during sleep. In patients with frequent periodic leg movement during sleep, dopaminergic therapy for control of leg movements in patients with restless legs syndrome reduced risk of atrial fibrillation progression. Frequent leg movement during sleep in patients with restless legs syndrome is associated with progression of atrial fibrillation to persistent and permanent forms.

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Progression of Paroxysmal to Persistent Atrial Fibrillation

Cited by 17 publications

References 16 publications

The role of HATCH score in predicting the success rate of sinus rhythm following electrical cardioversion of atrial fibrillation

The role of HATCH score in predicting the success rate of sinus rhythm following electrical cardioversion of atrial fibrillation

Circulating Biomarkers Predictive of Postoperative Atrial Fibrillation

Frequent Periodic Leg Movement During Sleep Is an Unrecognized Risk Factor for Progression of Atrial Fibrillation

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