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Atrial fibrillation patterns and their cardiovascular risk profiles in the general population: the Rotterdam study

Martijn J Tilly1, Zuolin Lu1, Sven Geurts1

  • 1Department of Epidemiology, Erasmus MC University Medical Center, Office Na-2714, PO Box 2040, 3000 CA, Rotterdam, The Netherlands.

Clinical Research in Cardiology : Official Journal of the German Cardiac Society
|August 10, 2022
PubMed

Insights

A new method classifies atrial fibrillation (AF) patterns in populations. Long-standing persistent AF is linked to worse cardiovascular risk factor trajectories, with notable sex differences in AF development.

Area of Science:

  • Epidemiology
  • Cardiology
  • Public Health

Background:

  • Current atrial fibrillation (AF) classification relies on event duration, limiting its use in population studies.
  • A need exists for a standardized, population-level AF classification method.
  • Investigating cardiovascular risk factor trajectories preceding AF patterns is crucial.

Purpose of the Study:

  • To develop a simple, standardized method for classifying AF patterns in the general population.
  • To compare longitudinal cardiovascular risk factor trajectories before AF diagnosis across different AF patterns.
  • To examine sex-specific differences in these trajectories.

Main Methods:

  • Utilized data from the population-based Rotterdam Study (1990-2014).
  • Categorized participants into 'single-documented AF episode', 'multiple-documented AF episodes', or 'long-standing persistent AF'.
  • Employed linear mixed-effects models to analyze longitudinal risk factor evolution prior to AF diagnosis.

Main Results:

  • Included 14,061 participants (59.1% women).
  • Identified 1,137 (8.1%) with single AF, 208 (1.5%) with multiple AF episodes, and 57 (0.4%) with long-standing persistent AF.
  • Poorer weight and waist circumference trajectories preceded long-standing persistent AF in men; all risk factors showed worse trajectories in women with long-standing persistent AF.

Conclusions:

  • A novel, standardized method for classifying population-based AF patterns was developed.
  • Long-standing persistent AF is associated with poorer preceding cardiovascular risk factor trajectories.
  • Findings reveal sex differences in AF pathophysiology and potential risk factors.
Abstract

Keywords:
AnthropometricsArrhythmiaAtrial fibrillationAtrial fibrillation patternsRepeated measurementsRisk factors

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