Family history of atrial fibrillation as a predictor of atrial substrate and arrhythmia recurrence in patients undergoing atrial fibrillation catheter ablation

Kapur, Sunil; Kumar, Saurabh; John, Roy M.; Stevenson, William G.; Tedrow, Usha B.; Koplan, Bruce A.; Epstein, Laurence M.; MacRae, Calum A.; Michaud, Gregory F.

doi:10.1093/europace/eux107

Cited by 10 publications

(8 citation statements)

References 20 publications

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“…The recent work by Khan et al compiled 134 randomized studies and reported that 4.5% of AF patients had obstructive sleep apnea, 35.8% had coronary artery disease (CAD), 66.4% had diabetes mellitus, 75.4% had hypertension, 12.7% had dyslipidemia, 9.7% had chronic kidney disease (CKD), 44% had heart failure (HF), 45.5% had cerebrovascular accidents, and 9% had the chronic obstructive pulmonary disease (COPD) [ 13 ]. Indeed, multimorbidity is common in patients with AF and both non-cardiac and cardiac comorbidities clusters may be associated with an increased risk of major adverse outcomes of different manners [ 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 ].…”

Section: Discussionmentioning

confidence: 99%

“…All these data confirm the multi-complexity of the AF population, but our results underline the interest of stratification to optimize the understanding of AF and also to possibly optimize the management, whether pharmacological or non-pharmacological, of AF. Indeed, recent guidelines have recommended a more holistic or integrated approach to AF care, including stroke prevention, patient-centered decisions on rate- or rhythm control, and the optimization of comorbidities [ 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 ]. Adherence to such an approach has been associated with improved clinical outcomes [ 30 , 31 ].…”

Section: Discussionmentioning

confidence: 99%

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Prognosis of Atrial Fibrillation with or without Comorbidities: Analysis of Younger Adults from a Nationwide Database

Mertz

Cottin

Bentounes

et al. 2022

JCM

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Objective: To assess the prognosis of AF patients with or without cardiac or extra-cardiac concomitant conditions. Participants and Methods: All consecutive patients diagnosed with AF admitted to French hospitals between 2011 and 2020 were identified. Patients were classified into four groups: (1) > 60 yo; (2) with known cardiac disease (KCD group); (3) with extra-cardiac comorbidities (ECC); and 4) AF without KCD or ECC (“Lone AF”). Results: Altogether 2,435,541 patients were identified, from which 2,203,702 patients aged >60 years and 231,839 patients aged <60 years (with KCD (55.2%), with ECC (14.7%) and with “Lone AF” (30.1%)). During follow-up, the incidences of all-cause and CV deaths were 13.7%, 5.7%, 6.2%, and 2.3%, and 4.2%, 1.7%, 0.8%, and 0.3% in the older than 60 yo group, KCD group, ECC group and “Lone AF” AF group, respectively. In the age and sex-adjusted analysis (patients < 60 yo), patients with AF and KCD had worse outcomes than patients with “Lone AF” for all major cardiac events. Conclusion: There are three distinct prognostic criteria based on the presence or lack of HD or extra-cardiac concomitant comorbidities. Patients in the so-called “Lone AF” group remain severe in terms of CV events but still with a lower incidence than the patients with associated KCD or ECC. The presence of KCD or ECC makes it possible to distinguish a profile in terms of events that are very different between the patients.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Prognosis of Atrial Fibrillation with or without Comorbidities: Analysis of Younger Adults from a Nationwide Database

Mertz

Cottin

Bentounes

et al. 2022

JCM

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“…Zöller et al 20 demonstrated that the risk of recurrent lone AF hospitalization was 23% higher for individuals with affected parents and 30% higher for those with affected siblings in a nationwide family study in Sweden. A single‐centered, small‐sized (with 132 patients with FAF), retrospective study demonstrated that a positive FAF was associated with an increased risk of arrhythmia recurrence in patients with persistent AF, but not in paroxysmal AF patients after a single catheter ablation 13 . In the contrary, Shoemaker et al 21 used genetic susceptibility for AF as a surrogate of FAF, and found no association between high AF genetic susceptibility and recurrence after de novo AF ablation.…”

Section: Discussionmentioning

confidence: 99%

“…It is not known whether FAF has any impact on the risk of AT recurrence after AF ablation. One study has ever reported higher risk of AT recurrence in patients with FAF after initial catheter ablation, but the study was limited by small sample size 13 . In this study, we used data from a large Chinese AF cohort (China‐AF study) to determine whether FAF is a risk factor of AT recurrence after AF ablation.…”

Section: Introductionmentioning

confidence: 99%

Effect of family history of atrial fibrillation on recurrence after atrial fibrillation ablation: A report from the Chinese Atrial Fibrillation Registry Study

Jiang

et al. 2021

Cardiovasc electrophysiol

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Background To evaluate the impact of family history of atrial fibrillation (FAF) on postablation atrial tachyarrhythmia (AT) recurrence. Methods All the 8198 patients undergoing initial AF ablation registered in the Chinese Atrial Fibrillation Registry study were analyzed. FAF was defined as having first‐degree relatives diagnosed as AF at age 65 years or younger, and before the time the case in this study was diagnosed. Cox proportional hazards models were used to evaluate the impact of FAF on postablation AT recurrence. Age, sex, body mass index, AF type, history of congestive heart failure, hypertension, diabetes mellitus, prior stroke/transient ischemic attack/systemic embolism, vascular diseases, use of contact force‐sensing catheter, and completion of high school were adjusted. The definition of AT recurrence was any documented AF, atrial flutter, or AT lasting more than or equal to 30 s after 3 months blanking period. Results After a mean follow‐up of 26.2 ± 19.6 months, 318 out of the 645 patients (49.3%) with FAF and 3339 out of the 7553 patients (44.2%) without FAF experienced AT recurrence, corresponding to annual recurrence rates of 22.8% and 20.2%, respectively. Patients with FAF had a significant higher risk of AT recurrence (adjusted hazard ratio 1.129, 95% confidence interval 1.005–1.267) in multivariable analysis. Moreover, FAF had a significant higher impact on AT recurrence in the subgroup of patients diagnosed with AF at age 50 years or younger (p for interaction = .036). Conclusion FAF is a risk factor for postablation AT recurrence. This is especially true in those with AF diagnosed at 50 years or younger.

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“…2 The heterogeneous nature of AF requires that physicians treat each patient according to their own risk profile. [31][32][33] However, patients may also present without clinical risk factors, and still develop AF. Prior studies show that a lower clinical risk profile is associated with higher AF genetic susceptibility.…”

Section: The Fifth Paradigm-using Atrial Fibrillation Genetics To Develop New Therapeuticsmentioning

confidence: 99%

Role of genetics in atrial fibrillation management

2021

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Atrial fibrillation (AF) management has significantly improved during the career of professor Crijns. Research was implemented into guidelines and clinical practice. However, despite advances in AF management, large differences between individual treatment responses still exist and the mechanisms underlying initiation and perpetuation of AF are not completely understood. International collaborations have revealed the genetic contribution to AF and steps towards improving AF management are being made. In this short review, the most important paradigms shifts in the field of AF genetics are recognized and the future role of genetics in personalized management of AF is discussed.

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Family history of atrial fibrillation as a predictor of atrial substrate and arrhythmia recurrence in patients undergoing atrial fibrillation catheter ablation

Cited by 10 publications

References 20 publications

Prognosis of Atrial Fibrillation with or without Comorbidities: Analysis of Younger Adults from a Nationwide Database

Prognosis of Atrial Fibrillation with or without Comorbidities: Analysis of Younger Adults from a Nationwide Database

Effect of family history of atrial fibrillation on recurrence after atrial fibrillation ablation: A report from the Chinese Atrial Fibrillation Registry Study

Role of genetics in atrial fibrillation management

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