2024-03-29T08:48:20Zhttp://repisalud.isciii.es/oai/requestoai:repisalud.isciii.es:20.500.12105/103552023-12-04T10:42:18Zcom_20.500.12105_2145com_20.500.12105_2051com_20.500.12105_2144col_20.500.12105_2146
Repisalud
author
Lillo-Castellano, Jose Maria
author
González-Ferrer, Juan José
author
Marina-Breysse, Manuel
author
Martínez-Ferrer, José Bautista
author
Pérez-Álvarez, Luisa
author
Alzueta, Javier
author
Martínez, Juan Gabriel
author
Rodríguez, Aníbal
author
Rodríguez-Pérez, Juan Carlos
author
Anguera, Ignasi
author
Viñolas, Xavier
author
García-Alberola, Arcadio
author
Quintanilla, Jorge G.
author
Alfonso-Almazan, Jose M.
author
García, Javier
author
Borrego, Luis
author
Cañadas-Godoy, Victoria
author
Pérez-Castellano, Nicasio
author
Pérez-Villacastín, Julián
author
Jiménez-Díaz, Javier
author
Jalife, Jose
author
Filgueiras-Rama, David
funder
Instituto de Salud Carlos III
funder
Ministerio de Ciencia, Innovación y Universidades (España)
funder
Unión Europea. Fondo Europeo de Desarrollo Regional (FEDER/ERDF)
funder
Sociedad Española de Cardiología
funder
NIH - National Heart, Lung, and Blood Institute (NHLBI) (Estados Unidos)
funder
National Institutes of Health (Estados Unidos)
2020-06-11T11:43:21Z
2020-06-11T11:43:21Z
2020-05-01
Europace. 2020; 22(5):704-715
http://hdl.handle.net/20.500.12105/10355
31840163
10.1093/europace/euz331
1532-2092
Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology
Atrial 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.
eng
Personalized monitoring of electrical remodelling during atrial fibrillation progression via remote transmissions from implantable devices.
journal article
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URL
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