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https://hdl.handle.net/2440/73712
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dc.contributor.author | Brooks, A. | - |
dc.contributor.author | Rangnekar, G. | - |
dc.contributor.author | Ganesan, A. | - |
dc.contributor.author | Salna, I. | - |
dc.contributor.author | Middeldorp, M. | - |
dc.contributor.author | Kuklik, P. | - |
dc.contributor.author | Baumert, M. | - |
dc.contributor.author | Roberts-Thomson, K. | - |
dc.contributor.author | Sanders, P. | - |
dc.date.issued | 2012 | - |
dc.identifier.citation | Heart Rhythm, 2012; 9(9):1367-1374 | - |
dc.identifier.issn | 1547-5271 | - |
dc.identifier.issn | 1556-3871 | - |
dc.identifier.uri | http://hdl.handle.net/2440/73712 | - |
dc.description.abstract | <h4>Background</h4>Atrial premature contractions (APCs) are well described to precede the initiation of paroxysmal atrial fibrillation (pAF). However, whether APC characteristics alter with progression of the arrhythmia is unknown.<h4>Objective</h4>To determine the APC characteristics in terms of burden and relative coupling interval with progression of the AF disease process.<h4>Methods</h4>Fifty consecutive patients with pAF, 50 consecutive patients with persistent AF (perAF), and 25 age-matched controls underwent clinical review, transthoracic echocardiography, and ambulatory electrocardiogram monitoring. After excluding 29 patients who had AF for the entire recording (n = 24) or unreliable recordings (n = 5), we analyzed data from 49 patients with pAF, 24 patients with perAF, and 23 healthy controls. All normal morphology R-R intervals with a >25% decrease in R-R coupling compared with the previous R-R interval (coupling interval index) were deemed APCs (n = 95,873).<h4>Results</h4>The median APC burden was higher in patients with pAF (2 [1-22] APCs/h; P = .004) and perAF (3 [1-6] APCs/h; P = .04) than in controls (1 [0-1] APCs/h) but was not different (P = .66) between the AF subgroups. Patients with pAF had a distinct increase in ectopy burden after 7 PM and elevation throughout the night (P = .002) in comparison with a blunted and complementary temporal response in the perAF cohort (P = .01). Patients with pAF demonstrated a greater proportion of shortly coupled APCs (29% [13-45]; P = .04) compared with persistent arrhythmia (17% [5-29]).<h4>Conclusions</h4>"Real-life" atrial trigger statistics of APC burden, timing, and diurnal rhythms track the transition from a trigger-based, autonomically sensitive paroxysmal arrhythmia to a more substrate-based persistent disease. | - |
dc.description.statementofresponsibility | Anthony G. Brooks, Geetanjali Rangnekar, Anand N. Ganesan, Ingrid Salna, Melissa E. Middeldorp, Pawel Kuklik, Mathias Baumert, Kurt C. Roberts-Thomson and Prashanthan Sanders | - |
dc.language.iso | en | - |
dc.publisher | Elsevier Inc. | - |
dc.rights | Crown Copyright © 2012 Published by Elsevier Inc. on behalf of Heart Rhythm Society. All rights reserved. | - |
dc.source.uri | http://dx.doi.org/10.1016/j.hrthm.2012.03.062 | - |
dc.subject | Heart Atria | - |
dc.subject | Humans | - |
dc.subject | Atrial Fibrillation | - |
dc.subject | Atrial Premature Complexes | - |
dc.subject | Disease Progression | - |
dc.subject | Electrocardiography, Ambulatory | - |
dc.subject | Risk Factors | - |
dc.subject | Case-Control Studies | - |
dc.subject | Heart Rate | - |
dc.subject | Time | - |
dc.subject | Middle Aged | - |
dc.subject | Female | - |
dc.subject | Male | - |
dc.subject | Statistics as Topic | - |
dc.title | Characteristics of ectopic triggers associated with paroxysmal and persistent atrial fibrillation: evidence for a changing role | - |
dc.type | Journal article | - |
dc.identifier.doi | 10.1016/j.hrthm.2012.03.062 | - |
dc.relation.grant | ARC | - |
pubs.publication-status | Published | - |
dc.identifier.orcid | Middeldorp, M. [0000-0002-4106-9771] | - |
dc.identifier.orcid | Kuklik, P. [0000-0001-8440-654X] | - |
dc.identifier.orcid | Baumert, M. [0000-0003-2984-2167] | - |
dc.identifier.orcid | Sanders, P. [0000-0003-3803-8429] | - |
Appears in Collections: | Aurora harvest 5 Medicine publications |
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