Incidence of Atrial Fibrillation and Relationship With Cardiovascular Events, Heart Failure, and Mortality

Vermond, Rob A.; Geelhoed, Bastiaan; Verweij, Niek; Tieleman, Robert G; Harst, Pim van der; Hillege, Hans L.; Gilst, Wiek H. van; Gelder, Isabelle C. Van; Rienstra, Michiel

doi:10.1016/j.jacc.2015.06.1314

Cited by 247 publications

(218 citation statements)

References 34 publications

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“…The population‐attributable risks of overweight status or obesity and abdominal obesity were calculated by subtracting the rate of AF in the entire cohort from the rate of AF in those who carried the risk factor and dividing it by the rate of AF in the entire cohort 28, 29…”

Section: Methodsmentioning

confidence: 99%

Associations of Abdominal Obesity and New‐Onset Atrial Fibrillation in the General Population

Baek

Yang

Kim

et al. 2017

JAHA

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BackgroundHigher height and weight are known to be associated with higher risk of atrial fibrillation (AF); however, whether the risk of AF is related to abdominal obesity is unclear.Methods and ResultsWe studied 501 690 adults (mean age: 47.6±14.3 years; 250 664 women [50.0%]) without baseline AF in the National Sample Cohort released by the National Health Insurance Service in Korea. Body mass index (underweight defined as <18.5; normal, 18.5 to <25.0; overweight, 25.0 to <30.0; and obese, ≥30.0) and waist circumference (abdominal obesity defined as ≥90 cm for men and ≥80 cm for women) were evaluated. During a mean follow‐up of 3.9±1.3 years, 3443 participants (1432 women [41.6%]) developed AF. In multivariable models adjusted for clinical variables, the AF risk of underweight, overweight, and obese individuals increased by 21% (95% confidence interval, 1.01–1.45, P=0.043), 14% (95% confidence interval, 1.06–1.23, P<0.001), and 52% (95% confidence interval, 1.30–1.78, P<0.001), respectively, compared with those with normal body mass index. AF risk with confounder‐adjusted hazards for abdominal obesity was 18% (95% confidence interval, 1.10–1.27, P<0.001). The increased AF risk was present in abdominally obese individuals regardless of body mass index except for the obese group. In subgroup analysis, abdominal obesity by waist circumference conferred increased risk of new‐onset AF, particularly in participants without comorbidities.ConclusionsAbdominal obesity is an important, potentially modifiable risk factor for AF in nonobese Asian persons. These data suggest that interventions to decrease abdominal obesity may reduce the population burden of AF.

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Section: Methodsmentioning

confidence: 99%

Associations of Abdominal Obesity and New‐Onset Atrial Fibrillation in the General Population

Baek

Yang

Kim

et al. 2017

JAHA

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“…In the general population, AF prevalence increases progressively with age and occurs predominantly in patients >60 years of age. 3 Beyond age, established risk factors for developing AF include male sex, hypertension, and obesity. 3 The recognition of a hereditary component has led to the discovery of predisposing genetic variants for AF.…”

Section: Af Prevalence and Detectionmentioning

confidence: 99%

“…3 Beyond age, established risk factors for developing AF include male sex, hypertension, and obesity. 3 The recognition of a hereditary component has led to the discovery of predisposing genetic variants for AF. 4 AF in patients with HCM appears to be 4-to 6-fold more common than in the general population, with a reported prevalence between 18% and 28% (Table 1).…”

Section: Af Prevalence and Detectionmentioning

confidence: 99%

Management of Atrial Fibrillation in Hypertrophic Cardiomyopathy

MacIntyre

Lakdawala

2016

Circulation

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C ase Presentation:A 38-year-old man with hypertrophic cardiomyopathy (HCM) was referred for management of intermittent palpitations and exertional dyspnea with routine activities despite escalated β-blocker therapy. His initial examination was notable for a regular pulse at 72 bpm and harsh systolic murmur that increased with the Valsalva maneuver. A 12-lead electrocardiography revealed sinus rhythm with increased QRS voltage, repolarization abnormalities, and a QTc of 430 milliseconds. Echocardiography was notable for severe asymmetrical hypertrophy (septal thickness, 22 mm), normal systolic function, severe outflow tract obstruction (70 mm Hg), and left atrial (LA) enlargement. A 24-hour Holter monitor detected 6 minutes of rapid atrial fibrillation (AF) that coincided with his palpitations. Therapy was recommended with warfarin to prevent stroke and with disopyramide to minimize outflow tract obstruction and frequency of AF. IntroductionHCM, which affects 0.2% of the population, is an important cause of heart failure and is the leading cause of nonviolent sudden death in the young. Traditionally defined as left ventricular hypertrophy that develops in the absence of abnormal hemodynamics, it is caused by dominant mutations in sarcomere genes.1 Prevention of sudden death and management of left ventricular outflow tract obstruction (LVOTO) have been the primary focus of HCM clinical research and management since its original descriptions. However, AF is more prevalent than either sudden death or medically refractory obstruction and is the most common sustained arrhythmia in HCM.2 The combination of HCM and AF is associated with a markedly increased risk of stroke, overall mortality, and heart failure. This Clinician Update focuses on the epidemiology, pathophysiology, and clinical management of AF in patients with HCM. AF Prevalence and DetectionAF represents the most common sustained arrhythmia in both the general and HCM populations. In the general population, AF prevalence increases progressively with age and occurs predominantly in patients >60 years of age.3 Beyond age, established risk factors for developing AF include male sex, hypertension, and obesity.3The recognition of a hereditary component has led to the discovery of predisposing genetic variants for AF. 4AF in patients with HCM appears to be 4-to 6-fold more common than in the general population, with a reported prevalence between 18% and 28% (Table 1). 2,[5][6][7][8] In light of the high prevalence of AF in HCM, the American Heart Association, American College of Cardiology, and European Society of Cardiology have included recommendations for AF screening in their contemporary practice guidelines (Table 2).9,10 The European Society of Cardiology guidelines advise that 48-hour ambulatory ECG monitoring should be performed (Class IIA recommendation) every 6 to 12 months in patients with LA anterior-posterior diameter ≥45 mm. 10 The 2011 American College of Cardiology/ American Heart Association guidelines are less stringent, stating that 24-hour a...

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“…Как СН с сохраненной ФВ (СНсФВ), так и ФП ассоциированы с пожилым возрастом, гипертензией и диастолической дисфункцией. Представляется, что эти состояния нераз-рывно связаны друг c другом и с негативными сердечно-сосудистыми проявлениями [6]. Фибрилляция предсер-дий является мощным независимым прогностическим фактором у пациентов с СН, повышающим риск смер-ти.…”

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Cardioprotective therapy in patients with atrial fibrillation and heart failure with preserved ejection fraction (Pilot study)

Tatarskiy¹,

Казеннова²,

Arutyunov³

2017

RHJ

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Incidence of Atrial Fibrillation and Relationship With Cardiovascular Events, Heart Failure, and Mortality

Cited by 247 publications

References 34 publications

Associations of Abdominal Obesity and New‐Onset Atrial Fibrillation in the General Population

Associations of Abdominal Obesity and New‐Onset Atrial Fibrillation in the General Population

Management of Atrial Fibrillation in Hypertrophic Cardiomyopathy

Cardioprotective therapy in patients with atrial fibrillation and heart failure with preserved ejection fraction (Pilot study)

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