Frequent atrial extrasystolic beats predict atrial fibrillation in patients with congenital heart defects

Teuwen, Christophe P.; Korevaar, Tim I M; Coolen, Rosa; Wel, Twan van der; Houck, Charlotte A.; Evertz, Reinder; Yaksh, Ameeta; Roos‐Hesselink, Jolien W.; Bogers, Ad J.J.C.; Groot, Natasja M.S. de

doi:10.1093/europace/euw300

Cited by 12 publications

(6 citation statements)

References 26 publications

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“…In a large cohort of 1,357 patients with various underlying diseases, Acharya et al demonstrated that patients with ≥100 AES/day have a higher risk for development of new‐onset AF (HR 2.97). Recently, this was also confirmed for patients with congenital heart disease . The predictive value of AES for development of AF recurrences was mainly examined after PVI in patients with PAF, whereas the present study evaluates the value of AES prior to PVI in both PAF and PeAF patients.…”

Section: Discussionmentioning

confidence: 68%

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Early markers of atrial fibrillation recurrence after pulmonary vein isolation

Lanters

Teuwen

Hokken

et al. 2020

Journal of Arrhythmia

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Background Postprocedural atrial extrasystole (AES) frequency predicts atrial fibrillation (AF) recurrence after pulmonary vein isolation (PVI) in patients with paroxysmal AF. However, the predictive value of preprocedural AES frequency is unknown. We investigate whether preprocedural AES frequency is a feasible marker to predict (timing of) AF recurrence after PVI. Methods Patients (N = 684) with paroxysmal or persistent AF undergoing first‐time PVI were evaluated for (a) the frequency of AES/day on Holter recordings without AF prior to PVI, (b) AF episodes during the 90 days blanking period, and (c) AF recurrences afterward. The correlation between AES/day and both development and timing of AF recurrences was tested. Results Preprocedural AES/day was similar in patients with paroxysmal (66 [20‐295] AES/day) and persistent AF (115 [12‐248] AES/day, P = .915). During the blanking period, 302 (44.2%) patients showed AF episodes. AF recurred in 379 (55.4%) patients at 203 (105‐400) days after PVI. AF recurred more frequently in patients with persistent (N = 104 [69.3%]) than in patients with paroxysmal AF (N = 275 [51.5%], P < .001). Frequency of AES prior to PVI was not correlated with development (P = .203) or timing (P = .478) of AF recurrences. AF recurrences occurred both more frequently (P < .001) and earlier (P < .000) in patients with AF during the blanking period. Conclusion AES/day prior to PVI is not correlated with (timing of) AF during the blanking period or AF recurrences, and is therefore not a feasible marker for AF recurrences in patients with PAF. AF during the blanking period is correlated with AF recurrence.

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Section: Discussionmentioning

confidence: 68%

“…The predictive value of AES for development of new‐onset AF has been widely studied . In a large cohort of 1,357 patients with various underlying diseases, Acharya et al demonstrated that patients with ≥100 AES/day have a higher risk for development of new‐onset AF (HR 2.97).…”

Section: Discussionmentioning

confidence: 99%

Early markers of atrial fibrillation recurrence after pulmonary vein isolation

Lanters

Teuwen

Hokken

et al. 2020

Journal of Arrhythmia

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“…The relationship between frequent AES and greater incidence of AF has been demonstrated in different populations. 20 , 21 There are only a few studies investigating the role of premature AES in initiation of postoperative AF after cardiac surgery. After Frost and colleagues 22 had demonstrated that premature AES could initiate postoperative AF, several studies demonstrated that the incidence of postoperative AF could be reduced by atrial overdrive pacing thereby suppressing atrial premature depolarizations.…”

Section: Discussionmentioning

confidence: 99%

Novel insights in pathophysiology of postoperative atrial fibrillation

et al. 2021

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Objectives: Atrial extrasystoles are usually benign; however, they can also trigger atrial fibrillation. It is most likely that if atrial extrasystoles provoke a larger amount of conduction disorders and a greater degree of endo-epicardial asynchrony, the risk of postoperative atrial fibrillation increases. To test this hypothesis, we investigated the effect of programmed atrial extrasystoles on endo-epicardial conduction and postoperative atrial fibrillation.

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“…Furthermore, an estimated prevalence of ~5% of the patients with a congenital heart disease develop AF due to a combination of flaws in embryogenesis and peri-and post-operative factors related to correction of the heart defect [8]. This so-called congenital AF is characterized by AF onset at a younger age, and these patients often rapidly progress from persistent to permanent AF [9,10]. However, not all AF patients present with predisposing 'wear and tear' or congenital AF.…”

Section: Introductionmentioning

confidence: 99%

Cytoskeletal Protein Variants Driving Atrial Fibrillation: Potential Mechanisms of Action

Wijk

Wijdeveld

et al. 2022

Cells

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The most common clinical tachyarrhythmia, atrial fibrillation (AF), is present in 1–2% of the population. Although common risk factors, including hypertension, diabetes, and obesity, frequently underlie AF onset, it has been recognized that in 15% of the AF population, AF is familial. In these families, genome and exome sequencing techniques identified variants in the non-coding genome (i.e., variant regulatory elements), genes encoding ion channels, as well as genes encoding cytoskeletal (-associated) proteins. Cytoskeletal protein variants include variants in desmin, lamin A/C, titin, myosin heavy and light chain, junctophilin, nucleoporin, nesprin, and filamin C. These cytoskeletal protein variants have a strong association with the development of cardiomyopathy. Interestingly, AF onset is often represented as the initial manifestation of cardiac disease, sometimes even preceding cardiomyopathy by several years. Although emerging research findings reveal cytoskeletal protein variants to disrupt the cardiomyocyte structure and trigger DNA damage, exploration of the pathophysiological mechanisms of genetic AF is still in its infancy. In this review, we provide an overview of cytoskeletal (-associated) gene variants that relate to genetic AF and highlight potential pathophysiological pathways that drive this arrhythmia.

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Frequent atrial extrasystolic beats predict atrial fibrillation in patients with congenital heart defects

Abstract: Atrial extrasystole occur relatively frequent in adult CHD patients compared with patients with other cardiac diseases. This is the first study that showed an association between an increased AES frequency and a higher risk of AF development in CHD patients.

Cited by 12 publications

References 26 publications

Early markers of atrial fibrillation recurrence after pulmonary vein isolation

Early markers of atrial fibrillation recurrence after pulmonary vein isolation

Novel insights in pathophysiology of postoperative atrial fibrillation

Cytoskeletal Protein Variants Driving Atrial Fibrillation: Potential Mechanisms of Action

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