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dc.contributor.authorLillo-Castellano, Jose Maria 
dc.contributor.authorGonzález-Ferrer, Juan José
dc.contributor.authorMarina-Breysse, Manuel 
dc.contributor.authorMartínez-Ferrer, José Bautista
dc.contributor.authorPérez-Álvarez, Luisa
dc.contributor.authorAlzueta, Javier
dc.contributor.authorMartínez, Juan Gabriel
dc.contributor.authorRodríguez, Aníbal
dc.contributor.authorRodríguez-Pérez, Juan Carlos
dc.contributor.authorAnguera, Ignasi
dc.contributor.authorViñolas, Xavier
dc.contributor.authorGarcía-Alberola, Arcadio
dc.contributor.authorQuintanilla, Jorge G. 
dc.contributor.authorAlfonso-Almazan, Jose M. 
dc.contributor.authorGarcía, Javier
dc.contributor.authorBorrego, Luis
dc.contributor.authorCañadas-Godoy, Victoria
dc.contributor.authorPérez-Castellano, Nicasio
dc.contributor.authorPérez-Villacastín, Julián
dc.contributor.authorJiménez-Díaz, Javier
dc.contributor.authorJalife, Jose 
dc.contributor.authorFilgueiras-Rama, David
dc.identifier.citationEuropace. 2020; 22(5):704-715es_ES
dc.description.abstractAtrial electrical remodelling (AER) is a transitional period associated with the progression and long-term maintenance of atrial fibrillation (AF). We aimed to study the progression of AER in individual patients with implantable devices and AF episodes. Observational multicentre study (51 centres) including 4618 patients with implantable cardioverter-defibrillator +/-resynchronization therapy (ICD/CRT-D) and 352 patients (2 centres) with pacemakers (median follow-up: 3.4 years). Atrial activation rate (AAR) was quantified as the frequency of the dominant peak in the signal spectrum of AF episodes with atrial bipolar electrograms. Patients with complete progression of AER, from paroxysmal AF episodes to electrically remodelled persistent AF, were used to depict patient-specific AER slopes. A total of 34 712 AF tracings from 830 patients (87 with pacemakers) were suitable for the study. Complete progression of AER was documented in 216 patients (16 with pacemakers). Patients with persistent AF after completion of AER showed ∼30% faster AAR than patients with paroxysmal AF. The slope of AAR changes during AF progression revealed patient-specific patterns that correlated with the time-to-completion of AER (R2 = 0.85). Pacemaker patients were older than patients with ICD/CRT-Ds (78.3 vs. 67.2 year olds, respectively, P < 0.001) and had a shorter median time-to-completion of AER (24.9 vs. 93.5 days, respectively, P = 0.016). Remote transmissions in patients with ICD/CRT-D devices enabled the estimation of the time-to-completion of AER using the predicted slope of AAR changes from initiation to completion of electrical remodelling (R2 = 0.45). The AF progression shows patient-specific patterns of AER, which can be estimated using available remote-monitoring technology.es_ES
dc.description.sponsorshipThe Centro Nacional de Investigaciones Cardiovasculares (CNIC) is supported by the Instituto de Salud Carlos III (ISCIII), the Ministerio de Ciencia, Innovacion y Universidades (MCNU), and the Pro CNIC Foundation and is a Severo Ochoa Center of Excellence (SEV-2015–0505). This study was supported by grants from the Fondo Europeo de Desarrollo Regional (CB16/11/00458) and the Spanish MCNU (SAF2016-80324-R). The study was also partially supported by the Fundacion Interhospitalaria para la Investigacion Cardiovascular (FIC, Madrid, Spain) and the Heart Rhythm Association of the Spanish Society of Cardiology (D.F.-R., J.J.G.-F.). J.J. is supported by R01 Grant HL122352 from the National Heart Lung and Blood Institute, USA National Institutes of Health.es_ES
dc.publisherEuropean Society of Cardiology (ESC) es_ES
dc.titlePersonalized monitoring of electrical remodelling during atrial fibrillation progression via remote transmissions from implantable devices.es_ES
dc.typejournal articlees_ES
dc.rights.licenseAtribución-NoComercial 4.0 Internacional*
dc.contributor.funderInstituto de Salud Carlos III 
dc.contributor.funderMinisterio de Ciencia, Innovación y Universidades (España) 
dc.contributor.funderUnión Europea. Fondo Europeo de Desarrollo Regional (FEDER/ERDF) 
dc.contributor.funderSociedad Española de Cardiología 
dc.contributor.funderNIH - National Heart, Lung, and Blood Institute (NHLBI) (Estados Unidos) 
dc.contributor.funderNational Institutes of Health (Estados Unidos) 
dc.identifier.journalEuropace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiologyes_ES
dc.repisalud.orgCNICCNIC::Grupos de investigación::Desarrollo Avanzado sobre Mecanismos y Terapias de las Arritmiases_ES
dc.repisalud.orgCNICCNIC::Grupos de investigación::Arritmias Cardíacases_ES
dc.rights.accessRightsopen accesses_ES

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