Paroxysmal and Non-Paroxysmal Atrial Fibrillation in Middle Eastern Patients: Clinical Features and the Use of Medications. Analysis of the Jordan Atrial Fibrillation (JoFib) Study

Abstract

(1) Background: Atrial fibrillation (AF) is the most common arrhythmia causing an increased risk of mortality and morbidity. It is classified into paroxysmal and non-paroxysmal AF depending on the duration and frequency of the episodes. (2) Aims: Our goal was to investigate and compare the clinical profiles, risk of co-morbidities, the use of oral anticoagulation, and outcomes of patients with paroxysmal and non-paroxysmal AF in inpatient and outpatient settings. (3) Methods: Data were extracted from 28 different hospitals and centers in Jordan with a total of 2160 patients enrolled in the study using an observational non-interventional study model. The clinical features and the use of oral anticoagulants were compared in patients with paroxysmal and non-paroxysmal AF. (4) Results: Paroxysmal AF was documented in 35.6% (769) of the patients and non-paroxysmal types in 63.9% (1380); in addition, the type of AF was unknown in 11 (0.5%) patients. Our results showed that non-paroxysmal AF patients tend to be older with more co-morbidities and higher CHA2DS2-VASC and HAS-BLED scores. They also have higher rates of hypertension and diabetes. Anticoagulant, antiarrhythmic, and diuretic agents, overall, were used more in non-paroxysmal AF than paroxysmal AF. Hospital admissions were also more frequent in non-paroxysmal AF due to various factors, some of which are heart failure, bleeding risk, and COPD. (5) Conclusions: Non-paroxysmal AF is more common among Jordanian AF patients. The prevalence of comorbidities and the use of different types of therapies, especially anticoagulants, were higher in these patients.

Calpain Regulation and Dysregulation—Its Effects on the Intercalated Disk

“…Atrial Fibrillation (AF) is characterized by initial brief yet infrequent irregular and rapid heart rhythms, sliding into more chronic and sustained arrhythmia episodes lasting for several hours or longer [95]. AF can assume different clinical types depending on the timing of sinus rhythm resolution: paroxysmal AF resolves within 7 days while sustained AF can either last longer than 7 days (persistent) or indefinitely (permanent) [96,97]. AF builds cyclically to gradually further its presentation; AF-induced electrical remodeling slows down electrical conduction and shortens the effective refractory period in the atria, which in turn encourages prolonged AF episodes.…”

Combining 3D SONAR with High Resolution Imaging to Improve Vision in Atrial Fibrillation Ablation

“…3 Permanent AF is when a patient decides to not to pursue further action to restore or maintain sinus rhythm. 3 Electrical and morphological remodeling occurs when molecular, cellular, and/or interstitial changes alter the size, mass, geometry and function of the heart, which can be associated with AF promotion. 4,5…”