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3. Previous Exercise Levels and Outcome in Patients with New Atrial Fibrillation: ‘Past Achievements Do Not Predict the Future’

Author

Lenting, Charlotte J., primary, Wijtvliet, E. P. J. Petra, additional, Koldenhof, Tim, additional, Bessem, Bram, additional, Pluymaekers, Nikki A. H. A., additional, Rienstra, Michiel, additional, Folkeringa, Richard J., additional, Bronzwaer, Patrick, additional, Elvan, Arif, additional, Elders, Jan, additional, Tukkie, Raymond, additional, Luermans, Justin G. L. M., additional, Van Kuijk, Sander M. J., additional, Tijssen, Jan G. P., additional, Van Gelder, Isabelle C., additional, Crijns, Harry J. G. M., additional, and Tieleman, Robert G., additional

Published
2024
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4. Prevalence of wild‐type transthyretin amyloidosis in a prospective heart failure cohort with preserved and mildly reduced ejection fraction: Results of the Amylo‐VIP‐HF study

Author

Tubben, Alwin, primary, Tingen, Hendrea S.A., additional, Prakken, Niek H.J., additional, van Empel, Vanessa P.M., additional, Gorter, Thomas M., additional, Meems, Laura M.G., additional, Manintveld, Olivier C., additional, Rienstra, Michiel, additional, Tieleman, Robert G., additional, Glaudemans, Andor W.J.M., additional, van Veldhuisen, Dirk J., additional, Slart, Riemer H.J.A., additional, Nienhuis, Hans L.A., additional, and van der Meer, Peter, additional

Published
2024
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5. Prevalence of wild-type transthyretin amyloidosis in a prospective heart failure cohort with preserved and mildly reduced ejection fraction:Results of the Amylo-VIP-HF study

Author

Tubben, Alwin, Tingen, Hendrea S. A., Prakken, Niek H. J., van Empel, Vanessa P. M., Gorter, Thomas M., Meems, Laura M. G., Manintveld, Olivier C., Rienstra, Michiel, Tieleman, Robert G., Glaudemans, Andor W. J. M., van Veldhuisen, Dirk J., Slart, Riemer H. J. A., Nienhuis, Hans L. A., van der Meer, Peter, Tubben, Alwin, Tingen, Hendrea S. A., Prakken, Niek H. J., van Empel, Vanessa P. M., Gorter, Thomas M., Meems, Laura M. G., Manintveld, Olivier C., Rienstra, Michiel, Tieleman, Robert G., Glaudemans, Andor W. J. M., van Veldhuisen, Dirk J., Slart, Riemer H. J. A., Nienhuis, Hans L. A., and van der Meer, Peter

Published
2024

6. Healthcare utilisation and quality of life according to atrial fibrillation burden, episode frequency and duration.

Author

Park Frausing, Maria Hee Jung, Van De Lande, Martijn, Linz, Dominik, Crijns, Harry J. G. M., Tieleman, Robert G., Hemels, Martin E. W., De Melis, Mirko, Schotten, Ulrich, Kronborg, Mads Brix, Nielsen, Jens C., Van Gelder, Isabelle, and Rienstra, Michiel

Subjects
EMERGENCY room visits, MEDICAL sciences, BOX plots (Graphs), PERIPHERAL vascular diseases, CHRONIC obstructive pulmonary disease, TACHYARRHYTHMIAS, ARRHYTHMIA
Published
2024
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7. Women have less progression of paroxysmal atrial fibrillation: data from the RACE V study

Author

Mulder, Bart A, primary, Khalilian Ekrami, Neda, additional, Van De Lande, Martijn E, additional, Nguyen, Bao-Oanh, additional, Weberndorfer, Vanessa, additional, Crijns, Harry J, additional, Geelhoed, Bastiaan, additional, Blaauw, Yuri, additional, Hemels, Martin EW, additional, Tieleman, Robert G, additional, Scheerder, Coert OS, additional, De Melis, Mirko, additional, Schotten, Ulrich, additional, Linz, Dominik, additional, Van Gelder, Isabelle C, additional, and Rienstra, Michiel, additional

Published
2023
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9. Research Priorities in Atrial Fibrillation Screening: A Report From a National Heart, Lung, and Blood Institute Virtual Workshop

Author

Benjamin, Emelia J., Go, Alan S., Desvigne-Nickens, Patrice, Anderson, Christopher D., Casadei, Barbara, Chen, Lin Y., Crijns, Harry J.G.M., Freedman, Ben, Hills, Mellanie True, Healey, Jeff S., Kamel, Hooman, Kim, Dong-Yun, Link, Mark S., Lopes, Renato D., Lubitz, Steven A., McManus, David D., Noseworthy, Peter A., Perez, Marco V., Piccini, Jonathan P., Schnabel, Renate B., Singer, Daniel E., Tieleman, Robert G., Turakhia, Mintu P., Van Gelder, Isabelle C., Cooper, Lawton S., and Al-Khatib, Sana M.

Published
2021
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11. Prevalence and Incidence of Atrial Fibrillation in Heart Failure with Mildly Reduced or Preserved Ejection Fraction: (Additive) Value of Implantable Loop Recorders

Author

Gorter, Thomas M., primary, van Veldhuisen, Dirk J., additional, Mulder, Bart A., additional, Artola Arita, Vicente A., additional, van Empel, Vanessa P. M., additional, Manintveld, Olivier C., additional, Tieleman, Robert G., additional, Maass, Alexander H., additional, Vernooy, Kevin, additional, van Gelder, Isabelle C., additional, and Rienstra, Michiel, additional

Published
2023
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12. Brady- and tachyarrhythmias detected by continuous rhythm monitoring in paroxysmal atrial fibrillation

Author

Frausing, Maria Hee Jung Park, primary, Van De Lande, Martijn E, additional, Maass, Alexander H, additional, Nguyen, Bao-Oanh, additional, Hemels, Martin E W, additional, Tieleman, Robert G, additional, Koldenhof, Tim, additional, De Melis, Mirko, additional, Linz, Dominik, additional, Schotten, Ulrich, additional, Weberndörfer, Vanessa, additional, Crijns, Harry J G M, additional, Van Gelder, Isabelle C, additional, Nielsen, Jens Cosedis, additional, and Rienstra, Michiel, additional

Published
2023
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13. Clinical utility of the 4S-AF scheme in predicting progression of atrial fibrillation: data from the RACE V study

Author

Artola Arita, Vicente, primary, Van De Lande, Martijn E, additional, Khalilian Ekrami, Neda, additional, Nguyen, Bao-Oanh, additional, Van Melle, Joost M, additional, Geelhoed, Bastiaan, additional, De With, Ruben R, additional, Weberndörfer, Vanessa, additional, Erküner, Ömer, additional, Hillege, Hans, additional, Linz, Dominik, additional, Ten Cate, Hugo, additional, Spronk, Henri M H, additional, Koldenhof, Tim, additional, Tieleman, Robert G, additional, Schotten, Ulrich, additional, Crijns, Harry J G M, additional, Van Gelder, Isabelle C, additional, and Rienstra, Michiel, additional

Published
2023
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14. Prevalence and Incidence of Atrial Fibrillation in Heart Failure with Mildly Reduced or Preserved Ejection Fraction:(Additive) Value of Implantable Loop Recorders

Author

Gorter, Thomas M., van Veldhuisen, Dirk J., Mulder, Bart A., Artola Arita, Vicente A., van Empel, Vanessa P.M., Manintveld, Olivier C., Tieleman, Robert G., Maass, Alexander H., Vernooy, Kevin, van Gelder, Isabelle C., Rienstra, Michiel, Gorter, Thomas M., van Veldhuisen, Dirk J., Mulder, Bart A., Artola Arita, Vicente A., van Empel, Vanessa P.M., Manintveld, Olivier C., Tieleman, Robert G., Maass, Alexander H., Vernooy, Kevin, van Gelder, Isabelle C., and Rienstra, Michiel

Abstract

Background: Atrial fibrillation (AF) is common in heart failure with mildly reduced or preserved ejection fraction (HFmrEF/HFpEF) and has a negative impact on outcome. Reliable data on prevalence, incidence, and detection of AF from contemporary, prospective HFmrEF/HFpEF studies are scarce. Methods: This was a prespecified sub-analysis from a prospective, multicenter study. Patients with HFmrEF/HFpEF underwent 12-lead electrocardiography (ECG), 24 h Holter monitoring, and received an implantable loop recorder (ILR) at the study start. During the 2 year follow-up, rhythm monitoring was performed via ILR, yearly ECG, and two yearly 24 h Holter monitors. Results: A total of 113 patients were included (mean age 73 ± 8 years, 75% HFpEF). At baseline, 70 patients (62%) had a diagnosis of AF: 21 paroxysmal, 18 persistent, and 31 permanent AF. At study start, 45 patients were in AF. Of the 43 patients without a history of AF, 19 developed incident AF during a median follow-up of 23 [15–25] months (44%; incidence rate 27.1 (95% confidence interval 16.3–42.4) per 100 person-years). Thus, after the 2-year follow-up, 89 patients (79%) had a diagnosis of AF. In 11/19 incident AF cases (i.e., 58%), AF was solely detected on the ILR. Yearly 12-lead ECG detected six incident AF cases and four of these cases were also detected on two yearly 24 h Holter monitors. Two incident AF cases were detected on an unplanned ECG/Holter. Conclusions: Atrial fibrillation is extremely common in heart failure with HFmrEF/HFpEF and may inform on symptom evaluation and treatment options. AF screening with an ILR had a much higher diagnostic yield than conventional modalities.

Published
2023

15. Clinical utility of the 4S-AF scheme in predicting progression of atrial fibrillation:data from the RACE V study

Author

Arita, Vicente Artola, Van de Lande, Martijn E., Ekrami, Neda Khalilian, Nguyen, Bao-Oanh, Van Melle, Joost M., Geelhoed, Bastiaan, De With, Ruben R., Weberndorfer, Vanessa, Erkuner, Omer, Hillege, Hans, Linz, Dominik, Ten Cate, Hugo, Spronk, Henri M. H., Koldenhof, Tim, Tieleman, Robert G., Schotten, Ulrich, Crijns, Harry J. G. M., Van Gelder, Isabelle C., Rienstra, Michiel, Arita, Vicente Artola, Van de Lande, Martijn E., Ekrami, Neda Khalilian, Nguyen, Bao-Oanh, Van Melle, Joost M., Geelhoed, Bastiaan, De With, Ruben R., Weberndorfer, Vanessa, Erkuner, Omer, Hillege, Hans, Linz, Dominik, Ten Cate, Hugo, Spronk, Henri M. H., Koldenhof, Tim, Tieleman, Robert G., Schotten, Ulrich, Crijns, Harry J. G. M., Van Gelder, Isabelle C., and Rienstra, Michiel

Abstract

Aims The recent 4S-AF (scheme proposed by the 2020 ESC AF guidelines to address stroke risk, symptom severity, severity of AF burden and substrate of AF to provide a structured phenotyping of AF patients in clinical practice to guide therapy and assess prognosis) scheme has been proposed as a structured scheme to characterize patients with atrial fibrillation (AF). We aimed to assess whether the 4S-AF scheme predicts AF progression in patients with self-terminating AF. Methods and results We analysed 341 patients with self-terminating AF included in the well-phenotyped Reappraisal of Atrial Fibrillation: Interaction between HyperCoagulability, Electrical remodelling, and Vascular Destabilization in the Progression of AF (RACE V) study. Patients had continuous monitoring with implantable loop recorders or pacemakers. AF progression was defined as progression to persistent or permanent AF or progression of self-terminating AF with >3% burden increase. Progression of AF was observed in 42 patients (12.3%, 5.9% per year). Patients were given a score based on the components of the 4S-AF scheme. Mean age was 65 [interquartile range (IQR) 58-71] years, 149 (44%) were women, 103 (49%) had heart failure, 276 (81%) had hypertension, and 38 (11%) had coronary artery disease. Median CHA(2)DS(2)-VASc (the CHA(2)DS(2)-VASc score assesses thromboembolic risk. C, congestive heart failure/left ventricular dysfunction; H, hypertension; A(2), age >= 75 years; D, diabetes mellitus; S-2, stroke/transient ischaemic attack/systemic embolism; V, vascular disease; A, age 65-74 years; Sc, sex category (female sex)) score was 2 (IQR 2-3), and median follow-up was 2.1 (1.5-2.6) years. The average score of the 4S-AF scheme was 4.6 +/- 1.4. The score points from the 4S-AF scheme did not predict the risk of AF progression [odds ratio (OR) 1.1 95% CI 0.88-1.41, C-statistic 0.53]. However, excluding the symptoms domain, resulting in the 3S-AF (4S-AF scheme without the domain symptom severi

Published
2023

16. Healthcare utilisation and quality of life according to atrial fibrillation burden, episode frequency and duration

Author

Frausing, Maria Hee Jung Park, Van De Lande, Martijn, Linz, Dominik, Crijns, Harry J G M, Tieleman, Robert G, Hemels, Martin E W, De Melis, Mirko, Schotten, Ulrich, Kronborg, Mads Brix, Nielsen, Jens C, Van Gelder, Isabelle, and Rienstra, Michiel

Abstract

BackgroundWe aimed to evaluate the association between atrial fibrillation (AF) burden, duration and number of episodes with healthcare utilisation and quality of life in patients with early paroxysmal AF without a history of AF.MethodsIn this observational cohort study, we included 417 patients with paroxysmal AF from the Reappraisal of Atrial Fibrillation: interaction between hyperCoagulability, Electrical remodelling and Vascular destabilisation in the progression of AF (RACE V) Study. Patients were monitored with an insertable cardiac monitor for 1 year. Outcomes collected were healthcare utilisation, and quality of life assessed using the Atrial Fibrillation Severity Scale and EuroQol EQ-5D-5L questionnaires.ResultsDuring 1 year of follow-up, 63 973 AF episodes were detected in 353 (85%) patients. The median AF burden was 0.7% (IQR 0.1–4.0%). AF ablation was performed more frequently in patients with intermediate-to-high AF burdens (>0.2%) (16.2% vs 5.9%, p=0.01) and longer AF episode duration (>1 hour) (15.8% vs 2.0%, p=0.01), whereas cardioversions were more frequent in patients with longer episode duration (>1 hour) (9.5% vs 0%, p=0.04) and intermediate (0.2–1.9%) (but not high) AF burdens (13.6% vs 4.2%, p=0.01). Patients with many episodes (>147) reported higher symptom severity (p=0.001). No differences in symptom severity nor in EQ-5D-5L scores according to AF burden or duration were observed.ConclusionIn patients with early paroxysmal AF, higher AF burden and longer episode duration were associated with increased rates of healthcare utilisation but not with symptoms and quality of life. Patients with a higher number of episodes experienced more severe symptoms.Trial registration numberNCT02726698.

Published
2024
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17. Antiarrhythmic drugs in patients with early persistent atrial fibrillation and heart failure: results of the RACE 3 study

Author

Al-Jazairi, Meelad I H, Nguyen, Bao-Oanh, De With, Ruben R, Smit, Marcelle D, Weijs, Bob, Hobbelt, Anne H, Alings, Marco, Tijssen, Jan G P, Geelhoed, Bastiaan, Hillege, Hans L, Tieleman, Robert G, Van Veldhuisen, Dirk J, Crijns, Harry J G M, Van Gelder, Isabelle C, Blaauw, Yuri, Rienstra, Michiel, MUMC+: MA Med Staf Spec Cardiologie (9), RS: Carim - H01 Clinical atrial fibrillation, Cardiologie, MUMC+: MA Cardiologie (9), Groningen Kidney Center (GKC), Life Course Epidemiology (LCE), Cardiovascular Centre (CVC), Cardiology, and ACS - Heart failure & arrhythmias

Subjects
Male, medicine.medical_specialty, medicine.medical_treatment, Heart failure, Cardioversion, Amiodarone, TERM, Ventricular Function, Left, Early persistent atrial fibrillation, AFFIRM, SOTALOL, Clinical Research, Physiology (medical), Internal medicine, medicine, Humans, AcademicSubjects/MED00200, Sinus rhythm, Flecainide, Aged, business.industry, Sotalol, Stroke Volume, Atrial fibrillation, Middle Aged, medicine.disease, EFFICACY, PREVENTION, Antiarrhythmic drugs, Dronedarone, AMIODARONE, CARDIOVERSION, MAINTENANCE, SAFETY, Cardiology, Female, Rhythm control, SINUS RHYTHM, Cardiology and Cardiovascular Medicine, business, Anti-Arrhythmia Agents, medicine.drug
Abstract

Aims Maintaining sinus rhythm in patients with persistent atrial fibrillation (AF) is challenging. We explored the efficacy of class I and III antiarrhythmic drugs (AADs) in patients with persistent AF and mild to moderate heart failure (HF). Methods and results In the RACE 3 trial, patients with early persistent symptomatic AF and short history of mild to moderate HF with preserved or reduced left ventricular ejection fraction (LVEF) were randomized to targeted or conventional therapy. Both groups received AF and HF guideline-driven treatment. Additionally, the targeted-group received mineralocorticoid receptor antagonists, statins, angiotensin-converting enzyme inhibitors and/or receptor blockers, and cardiac rehabilitation. Class I and III AADs could be instituted in case of symptomatic recurrent AF. Eventually, pulmonary vein isolation could be performed. Primary endpoint was sinus rhythm on 7-day Holter after 1-year. Included were 245 patients, age 65 ± 9 years, 193 (79%) men, AF history was 3 (2–6) months, HF history 2 (1–4) months, 72 (29.4%) had HF with reduced LVEF. After baseline electrical cardioversion (ECV), 190 (77.6%) had AF recurrences; 108 (56.8%) received class I/III AADs; 19 (17.6%) flecainide, 36 (33.3%) sotalol, 3 (2.8%) dronedarone, 50 (46.3%) amiodarone. At 1-year 73 of 108 (68.0%) patients were in sinus rhythm, 44 (40.7%) without new AF recurrences. Maintenance of sinus rhythm was significantly better with amiodarone [n = 29/50 (58%)] compared with flecainide [n = 6/19 (32%)] and sotalol/dronedarone [n = 9/39 (23%)], P = 0.0064. Adverse events occurred in 27 (25.0%) patients, were all minor and reversible. Conclusion In stable HF patients with early persistent AF, AAD treatment was effective in nearly half of patients, with no serious adverse effects reported.

Published
2021
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18. Initial experience with pulsed field ablation for atrial fibrillation

Author

Magni, Federico T., primary, Mulder, Bart A., additional, Groenveld, Hessel F., additional, Wiesfeld, Ans C. P., additional, Tieleman, Robert G., additional, Cox, Moniek G., additional, Van Gelder, Isabelle C., additional, Smilde, Tom, additional, Tan, Eng S., additional, Rienstra, Michiel, additional, and Blaauw, Yuri, additional

Published
2022
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19. Assessment of sex-related differences and outcome in patients who underwent cryoballoon pulmonary vein isolation for atrial fibrillation: an observational cohort study

Author

Ekrami, Neda Khalilian, primary, Magni, Federico T, additional, Dayalani, Vijay, additional, van Gelder, Isabelle C, additional, Groenveld, Hessel F, additional, Tieleman, Robert G, additional, Wiesfeld, Ans CP, additional, Tan, Eng S, additional, Rienstra, Michiel, additional, Blaauw, Yuri, additional, and Mulder, Bart A, additional

Published
2022
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22. Long-term outcome of targeted therapy of underlying conditions in patients with early persistent atrial fibrillation and heart failure

Author

Nguyen, Bao Oanh, Crijns, Harry J. G. M., Tijssen, Jan G. P., Geelhoed, Bastiaan, Hobbelt, Anne H., Hemels, Martin E. W., Mol, W. J. Myke, Weijs, Bob, Alings, Marco, Smit, Marcelle D., Tieleman, Robert G., Tukkie, Raymond, van Veldhuisen, Dirk J., van Gelder, Isabelle C., Rienstra, Michiel, van Gelder, I. C., Alings, M., Tieleman, R. G., Aksoy, I., Linssen, G. C. M., Bosker, H. A., Verdel, G. J. E., Cramer, E., Crijns, H. J. G. M., Tuininga, Y. S., van der Galiën, A., Hagens, V., de Ruiter, G. S., Cardiology, ACS - Heart failure & arrhythmias, Cardiovascular Centre (CVC), MUMC+: MA Cardiologie (9), Cardiologie, RS: Carim - H01 Clinical atrial fibrillation, and MUMC+: MA Med Staf Spec Cardiologie (9)

Subjects
REHABILITATION, medicine.medical_specialty, medicine.medical_treatment, Vascular damage Radboud Institute for Health Sciences [Radboudumc 16], Angiotensin-Converting Enzyme Inhibitors, Early persistent atrial fibrillation, Targeted therapy, Angiotensin Receptor Antagonists, Physiology (medical), Internal medicine, Atrial Fibrillation, medicine, Humans, Sinus rhythm, Risk factor, Mineralocorticoid Receptor Antagonists, CATHETER ABLATION, RISK, Heart Failure, Rehabilitation, business.industry, Atrial fibrillation, Cardiovascular outcome, Odds ratio, medicine.disease, Confidence interval, Treatment Outcome, Risk factors, Heart failure, Cardiology, Rhythm control, Hydroxymethylglutaryl-CoA Reductase Inhibitors, Cardiology and Cardiovascular Medicine, business
Abstract

Aims The Routine vs. Aggressive risk factor driven upstream rhythm Control for prevention of Early persistent atrial fibrillation (AF) in heart failure (HF) (RACE 3) trial demonstrated that targeted therapy of underlying conditions improved sinus rhythm maintenance at 1 year. We now explored the effects of targeted therapy on the additional co-primary endpoints; sinus rhythm maintenance and cardiovascular outcome at 5 years. Methods and results Patients with early persistent AF and mild-to-moderate stable HF were randomized to targeted or conventional therapy. Both groups received rhythm control therapy according to guidelines. The targeted group additionally received four therapies: angiotensin-converting enzyme inhibitors and/or angiotensin receptor blockers (ARBs), statins, mineralocorticoid receptor antagonists (MRAs), and cardiac rehabilitation. The presence of sinus rhythm and cardiovascular morbidity and mortality at 5-year follow-up were assessed. Two hundred and sixteen patients consented for long-term follow-up, 107 were randomized to targeted and 109 to conventional therapy. At 5 years, MRAs [76 (74%) vs. 10 (9%) patients, P < 0.001] and statins [81 (79%) vs. 59 (55%), P < 0.001] were used more in the targeted than conventional group. Angiotensin-converting enzyme inhibitors/ARBs and physical activity were not different between groups. Sinus rhythm was present in 49 (46%) targeted vs. 43 (39%) conventional group patients at 5 years (odds ratio 1.297, lower limit of 95% confidence interval 0.756, P = 0.346). Cardiovascular mortality and morbidity occurred in 20 (19%) in the targeted and 15 (14%) conventional group patients, P = 0.353. Conclusion In patients with early persistent AF and HF superiority of targeted therapy in sinus rhythm maintenance could not be preserved at 5-year follow-up. Cardiovascular outcome was not different between groups. Trial registration number Clinicaltrials.gov NCT00877643.

Published
2022
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24. Prevalence and determinants of atrial fibrillation progression in paroxysmal atrial fibrillation

Author

Nguyen, Bao-Oanh, primary, Weberndorfer, Vanessa, additional, Crijns, Harry JGM, additional, Geelhoed, Bastiaan, additional, Ten Cate, Hugo, additional, Spronk, Henri, additional, Kroon, Abraham, additional, De With, Ruben, additional, Al-Jazairi, Meelad, additional, Maass, Alexander H, additional, Blaauw, Yuri, additional, Tieleman, Robert G, additional, Hemels, Martin E W, additional, Luermans, Justin, additional, de Groot, Joris, additional, Allaart, Cornelis P, additional, Elvan, Arif, additional, De Melis, Mirko, additional, Scheerder, Coert, additional, van Zonneveld, Anton Jan, additional, Schotten, Ulrich, additional, Linz, Dominik, additional, Van Gelder, Isabelle, additional, and Rienstra, Michiel, additional

Published
2022
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26. Time of onset of atrial fibrillation and atrial fibrillation progression data from the RACE V study.

Author

Lande, Martijn E van de, Rama, Rajiv S, Koldenhof, Tim, Arita, Vicente Artola, Nguyen, Bao-Oanh, Deutekom, Colinda van, Weberndorfer, Vanessa, Crijns, Harry J G M, Hemels, Martin E W, Tieleman, Robert G, Melis, Mirko de, Schotten, Ulrich, Linz, Dominik, Gelder, Isabelle C Van, Rienstra, Michiel, and Investigators, for the RACE V

Abstract

Aims Atrial fibrillation (AF) progression is associated with adverse outcome, but the role of the circadian or diurnal pattern of AF onset remains unclear. We aim to assess the association between the time of onset of AF episodes with the clinical phenotype and AF progression in patients with self-terminating AF. Methods and results The Reappraisal of AF: Interaction Between Hypercoagulability, Electrical Remodelling, and Vascular Destabilization in the Progression of AF study included patients with self-terminating AF who underwent extensive phenotyping at baseline and continuous rhythm monitoring with an implantable loop recorder (ILR). In this subanalysis, ILR data were used to assess the development of AF progression and the diurnal pattern of AF onset: predominant (>80%) nocturnal AF, predominant daytime AF, or mixed AF without a predominant diurnal AF pattern. The median follow-up was 2.2 (1.6–2.8) years. The median age was 66 (59–71) years, and 117 (42%) were women. Predominant nocturnal (n = 40) and daytime (n = 43) AF onset patients had less comorbidities compared to that of mixed (n = 195) AF patients (median 2 vs. 2 vs. 3, respectively, P = 0.012). Diabetes was more common in the mixed group (12% vs. 5% vs. 0%, respectively, P = 0.031), whilst obesity was more frequent in the nocturnal group (38% vs. 12% vs. 27%, respectively, P = 0.028). Progression rates in the nocturnal vs. daytime vs. mixed groups were 5% vs. 5% vs. 24%, respectively (P = 0.013 nocturnal vs. mixed and P = 0.008 daytime vs. mixed group, respectively). Conclusion In self-terminating AF, patients with either predominant nocturnal or daytime onset of AF episodes had less associated comorbidities and less AF progression compared to that of patients with mixed onset of AF. Clinical trial registration NCT02726698 [ABSTRACT FROM AUTHOR]

Published
2023
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27. Clinical utility of the 4S-AF scheme in predicting progression of atrial fibrillation: data from the RACE V study.

Author

Arita, Vicente Artola, Lande, Martijn E Van De, Ekrami, Neda Khalilian, Nguyen, Bao-Oanh, Melle, Joost M Van, Geelhoed, Bastiaan, With, Ruben R De, Weberndörfer, Vanessa, Erküner, Ömer, Hillege, Hans, Linz, Dominik, Cate, Hugo Ten, Spronk, Henri M H, Koldenhof, Tim, Tieleman, Robert G, Schotten, Ulrich, Crijns, Harry J G M, Gelder, Isabelle C Van, and Rienstra, Michiel

Abstract

Aims The recent 4S-AF (scheme proposed by the 2020 ESC AF guidelines to address stroke risk, symptom severity, severity of AF burden and substrate of AF to provide a structured phenotyping of AF patients in clinical practice to guide therapy and assess prognosis) scheme has been proposed as a structured scheme to characterize patients with atrial fibrillation (AF). We aimed to assess whether the 4S-AF scheme predicts AF progression in patients with self-terminating AF. Methods and results We analysed 341 patients with self-terminating AF included in the well-phenotyped Reappraisal of Atrial Fibrillation: Interaction between HyperCoagulability, Electrical remodelling, and Vascular Destabilization in the Progression of AF (RACE V) study. Patients had continuous monitoring with implantable loop recorders or pacemakers. AF progression was defined as progression to persistent or permanent AF or progression of self-terminating AF with >3% burden increase. Progression of AF was observed in 42 patients (12.3%, 5.9% per year). Patients were given a score based on the components of the 4S-AF scheme. Mean age was 65 [interquartile range (IQR) 58–71] years, 149 (44%) were women, 103 (49%) had heart failure, 276 (81%) had hypertension, and 38 (11%) had coronary artery disease. Median CHA2DS2-VASc (the CHA2DS2–VASc score assesses thromboembolic risk. C, congestive heart failure/left ventricular dysfunction; H, hypertension; A2, age ≥ 75 years; D, diabetes mellitus; S2, stroke/transient ischaemic attack/systemic embolism; V, vascular disease; A, age 65–74 years; Sc, sex category (female sex)) score was 2 (IQR 2–3), and median follow-up was 2.1 (1.5–2.6) years. The average score of the 4S-AF scheme was 4.6 ± 1.4. The score points from the 4S-AF scheme did not predict the risk of AF progression [odds ratio (OR) 1.1 95% CI 0.88–1.41, C-statistic 0.53]. However, excluding the symptoms domain, resulting in the 3S-AF (4S-AF scheme without the domain symptom severity, only including stroke risk, severity of AF burden and substrate of AF) scheme, predicted the risk of progression (OR 1.59 95% CI 1.15–2.27, C-statistic 0.62) even after adjusting for sex and age. Conclusions In self-terminating AF patients, the 4S-AF scheme does not predict AF progression. The 3S-AF scheme, excluding the symptom domain, may be a more appropriate score to predict AF progression. Trial registration numbers Clinicaltrials.gov NCT02726698 for RACE V [ABSTRACT FROM AUTHOR]

Published
2023
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31. Risk, Clinical Course, and Outcome of Ischemic Stroke in Patients Hospitalized With COVID-19: A Multicenter Cohort Study

Author

Sluis, Wouter M., primary, Linschoten, Marijke, additional, Buijs, Julie E., additional, Biesbroek, J. Matthijs, additional, den Hertog, Heleen M., additional, Ribbers, Tessa, additional, Nieuwkamp, Dennis J., additional, van Houwelingen, Reinier C., additional, Dias, Andreas, additional, van Uden, Ingeborg W.M., additional, Kerklaan, Joost P., additional, Bienfait, H. Paul, additional, Vermeer, Sarah E., additional, de Jong, Sonja W., additional, Ali, Mariam, additional, Wermer, Marieke J.H., additional, de Graaf, Marieke T., additional, Brouwers, Paul J.A.M., additional, Asselbergs, Folkert W., additional, Kappelle, L. Jaap, additional, van der Worp, H. Bart, additional, Algra, Annemijn M., additional, Donders, Richard C.J.M., additional, Pruissen, D. Martijn O., additional, Kuijper, Aaf F.M., additional, van Ofwegen-Hanekamp, Clara E.E., additional, Hermanides, Rik S., additional, Haerkens-Arends, Hortence E., additional, Anthonio, Rutger L., additional, Emans, Mireille E., additional, Tio, René A., additional, ten Berg, Jur M., additional, Groenemeijer, Björn E., additional, Pisters, Ron, additional, van der Zee, P. Marc, additional, Siebelink, Hans-Marc J., additional, Verschure, Derk O., additional, Meijs, Matthijs F.L., additional, Schut, Astrid, additional, Tieleman, Robert G., additional, Hermans-van Ast, Wanda, additional, Schaap, Jeroen, additional, Jewbali, Lucia S., additional, Smits, Peter C., additional, van der Harst, Pim, additional, van Smeden, Maarten, additional, and van Gilst, Wiek H., additional

Published
2021
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32. Prevalence and determinants of atrial fibrillation progression in paroxysmal atrial fibrillation.

Author

Bao-Oanh Nguyen, Weberndorfer, Vanessa, Crijns, Harry J. G. M., Geelhoed, Bastiaan, Cate, Hugo Ten, Spronk, Henri, Kroon, Abraham, De With, Ruben, Al-Jazairi, Meelad, Maass, Alexander H., Blaauw, Yuri, Tieleman, Robert G., Hemels, Martin E. W., Luermans, Justin, de Groot, Joris, Allaart, Cornelis P., Elvan, Arif, De Melis, Mirko, Scheerder, Coert, and van Zonneveld, Anton Jan

Subjects
ATRIAL fibrillation, HEART failure
Published
2023
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34. Rate control drugs differ in the prevention of progression of atrial fibrillation

Author

Koldenhof, Tim, primary, Wijtvliet, Petra E P J, additional, Pluymaekers, Nikki A H A, additional, Rienstra, Michiel, additional, Folkeringa, Richard J, additional, Bronzwaer, Patrick, additional, Elvan, Arif, additional, Elders, Jan, additional, Tukkie, Raymond, additional, Luermans, Justin G L M, additional, van Kuijk, Sander M J, additional, Tijssen, Jan G P, additional, van Gelder, Isabelle C, additional, Crijns, Harry J G M, additional, and Tieleman, Robert G, additional

Published
2021
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36. Early atrial fibrillation detection and the transition to comprehensive management

Author

Linz, Dominik, Hermans, Astrid, Tieleman, Robert G., Linz, Dominik, Hermans, Astrid, and Tieleman, Robert G.

Abstract

Current atrial fibrillation (AF) guidelines recommend screening for AF in individuals above 65 years or with other characteristics suggestive of increased stroke risk. Several mobile health (mHealth) approaches are available to identify AF. Although most wearables or ECG machines include algorithms to detect AF, an ECG confirmation of AF is necessary to establish a suspected diagnosis of AF. Early detection of AF is important to allow early initiation of AF management, and early rhythm control therapy lowered risk of adverse cardiovascular outcomes among patients with early AF aged >75 or with a CHA2DS2-VASc score ≥2 and cardiovascular conditions in the EAST-AFNET 4 study. Strategies for early AF detection should be always linked to a comprehensive work-up infrastructure organized within an integrated care pathway to allow early initiation and guidance of AF treatment in newly detected AF patients. In this review article, we summarize strategies and mHealth approaches for early AF detection and the transition to early AF management including AF symptoms evaluation and assessment of AF progression as well as AF risk factors.

Published
2021

37. Aspirin versus vitamin K antagonist treatment guided by transoesophageal echocardiography in patients with atrial fibrillation: a pilot study

Author

Dinh, Trang, Baur, Leo H B, Pisters, Ron, Kamp, Otto, Verheugt, Freek W A, Smeets, Joep L R M, Cheriex, Emile C, Lindeboom, Jan-Eize, Heesen, Wilfred F, Tieleman, Robert G, Prins, Martin H, Crijns, Harry J G M, Dinh, T, Pisters, R, Tieleman, RG, Prins, MH, Crijns, HJGM, Crijns, HJGM, Dinh, T, Baur, LHB, Kamp, O, Prins, MH, Verheugt, FWA, Pisters, R, Limburg, M, de Zwaan, C, ten Cate, H, and Lip, GY

Published
2014
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38. Prevalence and determinants of atrial fibrillation progression in paroxysmal atrial fibrillation

Author

Nguyen, Bao-Oanh, Weberndorfer, Vanessa, Crijns, Harry JGM, Geelhoed, Bastiaan, Ten Cate, Hugo, Spronk, Henri, Kroon, Abraham, De With, Ruben, Al-Jazairi, Meelad, Maass, Alexander H, Blaauw, Yuri, Tieleman, Robert G, Hemels, Martin E W, Luermans, Justin, de Groot, Joris, Allaart, Cornelis P, Elvan, Arif, De Melis, Mirko, Scheerder, Coert, van Zonneveld, Anton Jan, Schotten, Ulrich, Linz, Dominik, Van Gelder, Isabelle, and Rienstra, Michiel

Abstract

ObjectiveAtrial fibrillation (AF) often progresses from paroxysmal AF (PAF) to more permanent forms. To improve personalised medicine, we aim to develop a new AF progression risk prediction model in patients with PAF.MethodsIn this interim-analysis of the Reappraisal of AF: Interaction Between HyperCoagulability, Electrical Remodelling, and Vascular Destabilisation in the Progression of AF study, patients with PAF undergoing extensive phenotyping at baseline and continuous rhythm monitoring during follow-up of ≥1 year were analysed. AF progression was defined as (1) progression to persistent or permanent AF or (2) progression of PAF with >3% burden increase. Multivariable analysis was done to identify predictors of AF progression.ResultsMean age was 65 (58–71) years, 179 (43%) were female. Follow-up was 2.2 (1.6–2.8) years, 51 of 417 patients (5.5%/year) showed AF progression. Multivariable analysis identified, PR interval, impaired left atrial function, mitral valve regurgitation and waist circumference to be associated with AF progression. Adding blood biomarkers improved the model (C-statistic from 0.709 to 0.830) and showed male sex, lower levels of factor XIIa:C1-esterase inhibitor and tissue factor pathway inhibitor, and higher levels of N-terminal pro-brain natriuretic peptide, proprotein convertase subtilisin/kexin type 9 and peptidoglycan recognition protein 1 were associated with AF progression.ConclusionIn patients with PAF, AF progression occurred in 5.5%/year. Predictors for progression included markers for atrial remodelling, sex, mitral valve regurgitation, waist circumference and biomarkers associated with coagulation, inflammation, cardiomyocyte stretch and atherosclerosis. These prediction models may help to determine risk of AF progression and treatment targets, but validation is needed.Trial registration numberNCT02726698.

Published
2023
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40. Temporal patterns and short-term progression of paroxysmal atrial fibrillation data from RACE V: data from RACE V

Author

De With, Ruben R, Erküner, Ömer, Rienstra, Michiel, Nguyen, Bao-Oanh, Körver, Frank W J, Linz, Dominik, Ten Cate, Hugo, Spronk, Henri, Kroon, Abraham A, Maass, Alexander H, Blaauw, Yuri, Tieleman, Robert G, Hemels, Martin E W, de Groot, Joris R, Elvan, Arif, de Melis, Mirko, Scheerder, Coert O S, Al-Jazairi, Meelad I H, Schotten, Ulrich, Luermans, Justin G L M, Crijns, Harry J G M, Van Gelder, Isabelle C, and Cardiovascular Centre (CVC)

Subjects
RISK, Rhythm monitoring, Atrial fibrillation burden, Paroxysmal atrial fibrillation, Atrial fibrillation progression, MANAGEMENT, Atrial fibrillation, STROKE
Abstract

Aims Atrial fibrillation (AF) often starts as a paroxysmal self-terminating arrhythmia. Limited information is available on AF patterns and episode duration of paroxysmal AF. In paroxysmal AF patients, we longitudinally studied the temporal AF patterns, the association with clinical characteristics, and prevalence of AF progression. Methods and results In this interim analysis of the Reappraisal of AF: Interaction Between HyperCoagulability, Electrical Remodelling, and Vascular Destabilisation in the Progression of AF (RACE V) registry, 202 patients with paroxysmal AF were followed with continuous rhythm monitoring (implantable loop recorder or pacemaker) for 6 months. Mean age was 64 +/- 9 years, 42% were women. Atrial fibrillation history was 2.1 (0.5-4.4) years, CHA(2)DS(2)-VASc 1.9 +/- 1.3, 101 (50%) had hypertension, 69 (34%) heart failure. One-third had no AF during follow-up. Patients with long episodes (>12 hours) were often men with more comorbidities (heart failure, coronary artery disease, higher left ventricular mass). Patients with higher AF burden (>2.5%) were older with more comorbidities (worse renal function, higher calcium score, thicker intima media thickness). In 179 (89%) patients, 1-year rhythm follow-up was available. On a quarterly basis, average daily AF burden increased from 3.2% to 3.8%, 5.2%, and 6.1%. Compared to the first 6 months, 111 (62%) patients remained stable during the second 6 months, 39 (22%) showed progression to longer AF episodes, 8 (3%) developed persistent AF, and 29 (16%) patients showed AF regression. Conclusion In paroxysmal AF, temporal patterns differ suggesting that paroxysmal AF is not one entity. Atrial fibrillation burden is low and determined by number of comorbidities. Atrial fibrillation progression occurred in a substantial number.

Published
2020

41. Design and rationale of DUTCH-AF: a prospective nationwide registry programme and observational study on long-term oral antithrombotic treatment in patients with atrial fibrillation

Author

HAG Trombose, Team Medisch, Circulatory Health, JC onderzoeksprogramma Cardiovascular Health, HAG Hart- Vaatziekten, Chu, Gordon, Seelig, Jaap, Trinks-Roerdink, Emmy M., van Alem, Anouk P., Alings, Marco, van den Bemt, Bart, Boersma, Lucas Va, Brouwer, Marc A., Cannegieter, Suzanne C., Ten Cate, Hugo, Kirchhof, Charles Jhj, Crijns, Harry Jgm, van Dijk, Ewoud J., Elvan, Arif, van Gelder, Isabelle C., de Groot, Joris R., den Hartog, Frank R., de Jong, Jonas Ssg, de Jong, Sylvie, Klok, Frederikus A., Lenderink, Timo, Luermans, Justin G., Meeder, Joan G., Pisters, Ron, Polak, Peter, Rienstra, Michiel, Smeets, Frans, Tahapary, Giovanni Jm, Theunissen, Luc, Tieleman, Robert G., Trines, Serge A., van der Voort, Pepijn, Geersing, Geert Jan, Rutten, Frans H., Hemels, Martin Ew, Huisman, Menno V., HAG Trombose, Team Medisch, Circulatory Health, JC onderzoeksprogramma Cardiovascular Health, HAG Hart- Vaatziekten, Chu, Gordon, Seelig, Jaap, Trinks-Roerdink, Emmy M., van Alem, Anouk P., Alings, Marco, van den Bemt, Bart, Boersma, Lucas Va, Brouwer, Marc A., Cannegieter, Suzanne C., Ten Cate, Hugo, Kirchhof, Charles Jhj, Crijns, Harry Jgm, van Dijk, Ewoud J., Elvan, Arif, van Gelder, Isabelle C., de Groot, Joris R., den Hartog, Frank R., de Jong, Jonas Ssg, de Jong, Sylvie, Klok, Frederikus A., Lenderink, Timo, Luermans, Justin G., Meeder, Joan G., Pisters, Ron, Polak, Peter, Rienstra, Michiel, Smeets, Frans, Tahapary, Giovanni Jm, Theunissen, Luc, Tieleman, Robert G., Trines, Serge A., van der Voort, Pepijn, Geersing, Geert Jan, Rutten, Frans H., Hemels, Martin Ew, and Huisman, Menno V.

Published
2020

42. Opportunistic screening versus usual care for diagnosing atrial fibrillation in general practice: a cluster randomised controlled trial

Author

HAG Hart- Vaatziekten, Circulatory Health, JC onderzoeksprogramma Cardiovasculaire Epidemiologie, General Practice & Nursing Science, Julius Centrum, Kaasenbrood, Femke, Hollander, Monika, de Bruijn, Steven Hm, Dolmans, Carlijn Pe, Tieleman, Robert G, Hoes, Arno W, Rutten, Frans H, HAG Hart- Vaatziekten, Circulatory Health, JC onderzoeksprogramma Cardiovasculaire Epidemiologie, General Practice & Nursing Science, Julius Centrum, Kaasenbrood, Femke, Hollander, Monika, de Bruijn, Steven Hm, Dolmans, Carlijn Pe, Tieleman, Robert G, Hoes, Arno W, and Rutten, Frans H

Published
2020

43. Effects of a simple cardiac rehabilitation program on improvement of self-reported physical activity in atrial fibrillation – Data from the RACE 3 study

Author

Nguyen, Bao Oanh, primary, Wijtvliet, E.P.J. Petra, additional, Hobbelt, Anne H., additional, De Vries, Simone I.M., additional, Smit, Marcelle D., additional, Tieleman, Robert G., additional, Van Veldhuisen, Dirk Jan, additional, Crijns, Harry J.G.M., additional, Van Gelder, Isabelle C., additional, and Rienstra, Michiel, additional

Published
2020
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44. Rate control drugs differ in the prevention of progression of atrial fibrillation.

Author

Koldenhof, Tim, Wijtvliet, Petra E P J, Pluymaekers, Nikki A H A, Rienstra, Michiel, Folkeringa, Richard J, Bronzwaer, Patrick, Elvan, Arif, Elders, Jan, Tukkie, Raymond, Luermans, Justin G L M, Kuijk, Sander M J van, Tijssen, Jan G P, Gelder, Isabelle C van, Crijns, Harry J G M, Tieleman, Robert G, van Kuijk, Sander M J, and van Gelder, Isabelle C

Subjects
ATRIAL fibrillation diagnosis, MYOCARDIAL depressants, RESEARCH, RESEARCH methodology, CATHETER ablation, ATRIAL fibrillation, EVALUATION research, TREATMENT effectiveness, COMPARATIVE studies, RANDOMIZED controlled trials, RESEARCH funding, ELECTRIC countershock
Abstract

Aims: We hypothesize that in patients with paroxysmal atrial fibrillation (AF), verapamil is associated with lower AF progression compared to beta blockers or no rate control.Methods and Results: In this pre-specified post hoc analysis of the RACE 4 randomized trial, the effect of rate control medication on AF progression in paroxysmal AF was analysed. Patients using Vaughan-Williams Class I or III antiarrhythmic drugs were excluded. The primary outcome was a composite of first electrical cardioversion (ECV), chemical cardioversion (CCV), or atrial ablation. Event rates are displayed using Kaplan-Meier curves and multivariable Cox regression analyses are used to adjust for baseline differences. Out of 666 patients with paroxysmal AF, 47 used verapamil, 383 used beta blockers, and 236 did not use rate control drugs. The verapamil group was significantly younger than the beta blocker group and contained more men than the no rate control group. Over a mean follow-up of 37 months, the primary outcome occurred in 17% in the verapamil group, 33% in the beta blocker group, and 33% in the no rate control group (P = 0.038). After adjusting for baseline characteristics, patients using verapamil have a significantly lower chance of receiving ECV, CCV, or atrial ablation compared to patients using beta blockers [hazard ratio (HR) 0.40, 95% confidence interval (CI) 0.19-0.83] and no rate control (HR 0.64, 95% CI 0.44-0.93).Conclusion: In patients with newly diagnosed paroxysmal AF, verapamil was associated with less AF progression, as compared to beta blockers and no rate control. [ABSTRACT FROM AUTHOR]

Published
2022
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48. Ventricular tachyarrhythmia detection by implantable loop recording in patients with heart failure and preserved ejection fraction: the VIP‐HF study

Author

van Veldhuisen, Dirk J., primary, van Woerden, Gijs, additional, Gorter, Thomas M., additional, van Empel, Vanessa P.M., additional, Manintveld, Olivier C., additional, Tieleman, Robert G., additional, Maass, Alexander H., additional, Vernooy, Kevin, additional, Westenbrink, B. Daan, additional, van Gelder, Isabelle C., additional, and Rienstra, Michiel, additional

Published
2020
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50. Design and rationale of DUTCH-AF: a prospective nationwide registry programme and observational study on long-term oral antithrombotic treatment in patients with atrial fibrillation

Author

Chu, Gordon, primary, Seelig, Jaap, additional, Trinks-Roerdink, Emmy M, additional, van Alem, Anouk P, additional, Alings, Marco, additional, van den Bemt, Bart, additional, Boersma, Lucas VA, additional, Brouwer, Marc A, additional, Cannegieter, Suzanne C, additional, ten Cate, Hugo, additional, Kirchhof, Charles JHJ, additional, Crijns, Harry JGM, additional, van Dijk, Ewoud J, additional, Elvan, Arif, additional, van Gelder, Isabelle C, additional, de Groot, Joris R, additional, den Hartog, Frank R, additional, de Jong, Jonas SSG, additional, de Jong, Sylvie, additional, Klok, Frederikus A, additional, Lenderink, Timo, additional, Luermans, Justin G, additional, Meeder, Joan G, additional, Pisters, Ron, additional, Polak, Peter, additional, Rienstra, Michiel, additional, Smeets, Frans, additional, Tahapary, Giovanni JM, additional, Theunissen, Luc, additional, Tieleman, Robert G, additional, Trines, Serge A, additional, van der Voort, Pepijn, additional, Geersing, Geert-Jan, additional, Rutten, Frans H, additional, Hemels, Martin EW, additional, and Huisman, Menno V, additional

Published
2020
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