Clinical profile and outcome of familial versus non-familial atrial fibrillation

Heidarali, Mona; Bakhshandeh, Hooman; Fazelifar, Amirfarjam; Haghjoo, Majid

doi:10.1016/j.ijcard.2020.03.080

Cited by 5 publications

(7 citation statements)

References 18 publications

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“…31 We also found a higher rate of familial AF in Iran. 32 Among the patients with nonvalvular AF, 55.1% received a rhythm control strategy, which was broadly similar to the data from German AFNET registry 36 and Euro Heart Survey. 5 This was mainly achieved by antiarrhythmic drugs and electrical cardioversion: PVIs were performed only in a small group of the patients before entry into the IRAF registry; 9% of the patients received an invasive intervention (including AF catheter ablation, surgical AF ablation, and AV junction ablation) for rate or rhythm control.…”

Section: Patient Characteristicssupporting

confidence: 76%

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A prospective survey of atrial fibrillation management in Iran: Baseline results of the Iranian Registry of Atrial Fibrillation (IRAF)

et al. 2021

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Atrial fibrillation (AF) is the most common cardiac arrhythmia globally and increases the risk of mortality and morbidity from stroke, systemic embolism, heart failure (HF), and dementia. [1][2][3] Several studies have demonstrated that AF is mainly associated with advancing age and underlying cardiovascular disease, particularly hypertension and coronary artery disease. Our current understanding of AF is largely based on data from North America and Europe. 4-7 Regional cohort studies have suggested that rheumatic heart disease, diabetes, obesity, and smoking are more important causes of AF than in other regions in the world. 8,9 There are racial and ethnic differences in AF symptom, treatment patterns, and outcomes. 9,10 During the previous four decades, several effective therapies for AF have been developed, 11,12 particularly, the use of direct-acting

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Section: Patient Characteristicssupporting

confidence: 76%

“…Population‐based study showed that the lifetime prevalence of cigarette smoking is moderately high among Iranian adults 31 . We also found a higher rate of familial AF in Iran 32 . This familial aggregation of AF may be because of both hereditary and shared environmental factors.…”

Section: Discussionsupporting

confidence: 53%

A prospective survey of atrial fibrillation management in Iran: Baseline results of the Iranian Registry of Atrial Fibrillation (IRAF)

et al. 2021

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“…]65 years old are more likely to receive a permanent pacemaker or implantable cardioverter-defibrillator (ICD). 81 Taken together, this stresses the importance of gathering a thorough family history in patients that are newly diagnosed with AF.…”

Section: Challenges Of Genetic Testingmentioning

confidence: 99%

Genetically Based Atrial Fibrillation: Current Considerations for Diagnosis and Management

Pensa

Baman

Puckelwartz

et al. 2022

Preprint

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Atrial fibrillation (AF) is the most common atrial arrhythmia and is subcategorized into numerous clinical phenotypes. Given its heterogeneity, investigations into the genetic mechanisms underlying AF have been pursued in recent decades, with predominant analyses focusing on early onset or lone AF. Linkage analyses, genome wide association studies (GWAS), and single gene analyses have led to the identification of rare and common genetic variants associated with AF risk. Significant overlap with genetic variants implicated in dilated cardiomyopathy syndromes, including truncating variants of the sarcomere protein titin, have been identified through these analyses, in addition to other genes associated with cardiac structure and function. Despite this, widespread utilization of genetic testing in AF remains hindered by the unclear impact of genetic risk identification on clinical outcomes and the high prevalence of variants of unknown significance (VUS). However, genetic testing is a reasonable option for patients with early onset AF and in those with significant family history of arrhythmia. While many knowledge gaps remain, emerging data support genotyping to inform selection of AF therapeutics. In this review we highlight the current understanding of the complex genetic basis of AF and explore the overlap of AF with inherited cardiomyopathy syndromes. We propose a set of criteria for clinical genetic testing in AF patients and outline future steps for the integration of genetics into AF care.

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“…Mounting evidence indicates the role of genetics as important predisposing factors in the development of AF [ 5 , 6 ]. Additionally, having a positive family history increases the risk of developing early-onset AF [ 7 – 11 ]. In familial cases, nearly 1 in 4 patients has a first-degree relative who suffers from AF [ 12 ].…”

Section: Introductionmentioning

confidence: 99%

“…In familial cases, nearly 1 in 4 patients has a first-degree relative who suffers from AF [ 12 ]. According to the Iranian Registry of Atrial Fibrillation, history of AF in a first-degree relative is positive in 15.3% of the Iranian AF population [ 7 , 13 ].…”

Section: Introductionmentioning

confidence: 99%

Whole-exome sequencing reveals a rare missense variant in DTNA in an Iranian pedigree with early-onset atrial fibrillation

Malakootian

Jalilian

Kalayinia

et al. 2022

BMC Cardiovasc Disord

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Atrial fibrillation (AF) is a morbid and heritable irregular cardiac rhythm that affects about 2%–3% of the population. Patients with early-onset AF have a strong genetic association with the disease; nonetheless, the exact underlying mechanisms need clarification. We herein present our evaluation of a 2-generation Iranian pedigree with early-onset AF. Whole-exome sequencing was applied to elucidate the genetic predisposition. Direct DNA sequencing was utilized to confirm and screen the variants in the proband and his available family members. The pathogenicity of the identified nucleotide variations was scrutinized via either segregation analysis in the family or in silico predictive software. The comprehensive variant analysis revealed a missense variant (c.G681C, p.E227D, rs1477078144) in the human α-dystrobrevin gene (DTNA), which is rare in genetic databases. Most in silico analyses have predicted this variant as a disease-causing variant, and the variant is co-segregated with the disease phenotype in the family. Previous studies have demonstrated the association between the DTNA gene and left ventricular noncompaction cardiomyopathy. Taken together, we provide the first evidence of an association between a nucleotide variation in the DTNA gene and early-onset AF in an Iranian family. However, the genetic testing of AF in the Iranian population is still limited. This finding not only further confirms the significant role of genetics in the incidence of early-onset AF but also expands the spectrum of the gene variations that lead to AF. Additionally, it may have further implications for the treatment and prevention of AF.

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Clinical profile and outcome of familial versus non-familial atrial fibrillation

Cited by 5 publications

References 18 publications

A prospective survey of atrial fibrillation management in Iran: Baseline results of the Iranian Registry of Atrial Fibrillation (IRAF)

A prospective survey of atrial fibrillation management in Iran: Baseline results of the Iranian Registry of Atrial Fibrillation (IRAF)

Genetically Based Atrial Fibrillation: Current Considerations for Diagnosis and Management

Whole-exome sequencing reveals a rare missense variant in DTNA in an Iranian pedigree with early-onset atrial fibrillation

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