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  1. Article ; Online: Systematic analysis of ECG predictors of sinus rhythm maintenance after electrical cardioversion for persistent atrial fibrillation.

    Lankveld, Theo / de Vos, Cees B / Limantoro, Ione / Zeemering, Stef / Dudink, Elton / Crijns, Harry J / Schotten, Ulrich

    Heart rhythm

    2016  Volume 13, Issue 5, Page(s) 1020–1027

    Abstract: Background: Electrical cardioversion (ECV) is one of the rhythm control strategies in patients with persistent atrial fibrillation (AF). Unfortunately, recurrences of AF are common after ECV, which significantly limits the practical benefit of this ... ...

    Abstract Background: Electrical cardioversion (ECV) is one of the rhythm control strategies in patients with persistent atrial fibrillation (AF). Unfortunately, recurrences of AF are common after ECV, which significantly limits the practical benefit of this treatment in patients with AF.
    Objectives: The objectives of this study were to identify noninvasive complexity or frequency parameters obtained from the surface electrocardiogram (ECG) to predict sinus rhythm (SR) maintenance after ECV and to compare these ECG parameters with clinical predictors.
    Methods: We studied a wide variety of ECG-derived time- and frequency-domain AF complexity parameters in a prospective cohort of 502 patients with persistent AF referred for ECV.
    Results: During 1-year follow-up, 161 patients (32%) maintained SR. The best clinical predictor of SR maintenance was antiarrhythmic drug (AAD) treatment. A model including clinical parameters predicted SR maintenance with a mean cross-validated area under the receiver operating characteristic curve (AUC) of 0.62 ± 0.05. The best single ECG parameter was the dominant frequency (DF) on lead V6. Combining several ECG parameters predicted SR maintenance with a mean AUC of 0.64 ± 0.06. Combining clinical and ECG parameters improved prediction to a mean AUC of 0.67 ± 0.05. Although the DF was affected by AAD treatment, excluding patients taking AADs did not significantly lower the predictive performance captured by the ECG.
    Conclusion: ECG-derived parameters predict SR maintenance during 1-year follow-up after ECV at least as good as known clinical predictors of rhythm outcome. The DF proved to be the most powerful ECG-derived predictor.
    MeSH term(s) Anti-Arrhythmia Agents/therapeutic use ; Atrial Fibrillation/diagnosis ; Atrial Fibrillation/physiopathology ; Atrial Fibrillation/therapy ; Drug Monitoring/methods ; Electric Countershock/adverse effects ; Electric Countershock/methods ; Electrocardiography/methods ; Female ; Heart Conduction System/physiopathology ; Heart Rate/drug effects ; Humans ; Male ; Netherlands ; Predictive Value of Tests ; Prospective Studies
    Chemical Substances Anti-Arrhythmia Agents
    Language English
    Publishing date 2016-01-08
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2229357-7
    ISSN 1556-3871 ; 1547-5271
    ISSN (online) 1556-3871
    ISSN 1547-5271
    DOI 10.1016/j.hrthm.2016.01.004
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  2. Article ; Online: Cardioversion of persistent atrial fibrillation is associated with a 24-hour relapse gap: Observations from prolonged postcardioversion rhythm monitoring.

    Weijs, Bob / Limantoro, Ione / Delhaas, Tammo / de Vos, Cees B / Blaauw, Yuri / Houben, Richard P M / Verheule, Sander / Pisters, Ronny / Crijns, Harry J G M

    Clinical cardiology

    2018  Volume 41, Issue 3, Page(s) 366–371

    Abstract: Background: Many recurrences occur after electrical cardioversion (ECV) of atrial fibrillation (AF). Assessment of extent of remodeling and continuous prolonged rhythm monitoring might reveal actionable recurrence mechanisms.: Hypothesis: After ECV ... ...

    Abstract Background: Many recurrences occur after electrical cardioversion (ECV) of atrial fibrillation (AF). Assessment of extent of remodeling and continuous prolonged rhythm monitoring might reveal actionable recurrence mechanisms.
    Hypothesis: After ECV of AF specific patterns of arrhythmia recurrence can be distinguished.
    Methods: All patients who underwent successful ECV due to persistent AF were included. Tissue velocity echocardiography during AF was performed before ECV to study atrial fibrillatory cycle length and fibrillatory velocity. After ECV, the heart rhythm of all patients was monitored 3 times daily during 4 weeks, and timing of recurrence was noted.
    Results: In total, 50 patients (68% male) were included; mean age was 68 ± 9 years. Median duration of the current AF episode was 102 (range, 74-152) days. Twenty-one (42%) patients showed recurrence of persistent AF. No recurrences occurred during the first 24 hours. There were no differences in clinical characteristics between patients with or without recurrence of AF. However, patients with early recurrence of AF had significantly higher precardioversion wall-motion velocity compared with patients who remained in sinus rhythm (2.8 [1.6-3.6] vs 1.4 [0.9-3.3] cm/s; P = 0.017), whereas atrial fibrillatory cycle length did not differ.
    Conclusions: In this study on 50 patients successfully cardioverted for persistent AF, there was a relapse gap of ≥24 hours. This phenomenon has not been well appreciated before and offers an AF-free window of opportunity for electrocardiographically triggered cardiac imaging or complex electrophysiological procedures. Echocardiographic tissue velocity imaging may visualize atrial remodeling relevant to AF recurrence.
    MeSH term(s) Aged ; Atrial Fibrillation/diagnosis ; Atrial Fibrillation/physiopathology ; Atrial Fibrillation/therapy ; Atrial Remodeling/physiology ; Chronic Disease ; Echocardiography ; Electric Countershock ; Electrocardiography ; Equipment Design ; Female ; Follow-Up Studies ; Heart Atria/diagnostic imaging ; Heart Atria/physiopathology ; Heart Rate/physiology ; Humans ; Male ; Monitoring, Physiologic/methods ; Recurrence ; Telemetry/instrumentation ; Time Factors ; Treatment Outcome
    Language English
    Publishing date 2018-03-22
    Publishing country United States
    Document type Journal Article ; Observational Study
    ZDB-ID 391935-3
    ISSN 1932-8737 ; 0160-9289
    ISSN (online) 1932-8737
    ISSN 0160-9289
    DOI 10.1002/clc.22877
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  3. Article ; Online: The fibrillating atrial myocardium visualized: an unexploited source of information.

    de Vos, Cees B / Crijns, Harry J G M / Tieleman, Robert G

    Heart rhythm

    2009  Volume 6, Issue 8, Page(s) 1247–1248

    MeSH term(s) Atrial Fibrillation/diagnostic imaging ; Atrial Fibrillation/physiopathology ; Blood Flow Velocity ; Heart Atria/diagnostic imaging ; Heart Atria/physiopathology ; Humans ; Myocardial Contraction ; Ultrasonography, Doppler
    Language English
    Publishing date 2009-08
    Publishing country United States
    Document type Case Reports ; Journal Article
    ZDB-ID 2229357-7
    ISSN 1556-3871 ; 1547-5271
    ISSN (online) 1556-3871
    ISSN 1547-5271
    DOI 10.1016/j.hrthm.2008.11.003
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  4. Article ; Online: Comprehensive upstream treatment for atrial fibrillation, when and how?

    Pisters, Ron / Nieuwlaat, Robby / de Vos, Cees B / Crijns, Harry J

    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

    2009  Volume 11, Issue 4, Page(s) 397–399

    MeSH term(s) Anti-Arrhythmia Agents/therapeutic use ; Anticoagulants/therapeutic use ; Atrial Fibrillation/epidemiology ; Atrial Fibrillation/therapy ; Echocardiography ; Electric Countershock ; Germany ; Guideline Adherence/trends ; Humans ; Hypertension ; Registries ; Risk Factors ; Stroke/prevention & control
    Chemical Substances Anti-Arrhythmia Agents ; Anticoagulants
    Language English
    Publishing date 2009-04
    Publishing country England
    Document type Comment ; Editorial
    ZDB-ID 1449879-0
    ISSN 1532-2092 ; 1099-5129
    ISSN (online) 1532-2092
    ISSN 1099-5129
    DOI 10.1093/europace/eup050
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  5. Article ; Online: Undetected paroxysmal atrial fibrillation in chronic heart failure patients: is it clinically relevant to catch the atrial phantom?

    Pisters, Ron / de Vos, Cees B / Dennert, Robert / Crijns, Harry J

    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

    2009  Volume 11, Issue 10, Page(s) 1257–1259

    MeSH term(s) Aged ; Atrial Fibrillation/diagnosis ; Atrial Fibrillation/epidemiology ; Cardiac Pacing, Artificial/utilization ; Cohort Studies ; Comorbidity ; False Negative Reactions ; Female ; Heart Failure/diagnosis ; Heart Failure/epidemiology ; Heart Failure/prevention & control ; Humans ; Incidence ; Male ; Reproducibility of Results ; Retrospective Studies ; Risk Assessment ; Risk Factors ; Sensitivity and Specificity ; Treatment Outcome ; United Kingdom/epidemiology
    Language English
    Publishing date 2009-10
    Publishing country England
    Document type Editorial ; Comment
    ZDB-ID 1449879-0
    ISSN 1532-2092 ; 1099-5129
    ISSN (online) 1532-2092
    ISSN 1099-5129
    DOI 10.1093/europace/eup268
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  6. Article ; Online: The influence of progression of atrial fibrillation on quality of life: a report from the Euro Heart Survey.

    Dudink, Elton A M P / Erküner, Ömer / Berg, Jenny / Nieuwlaat, Robby / de Vos, Cees B / Weijs, Bob / Capucci, Alessandro / Camm, A John / Breithardt, Günter / Le Heuzey, Jean-Yves / Luermans, Justin G L M / Crijns, Harry J G M

    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

    2017  Volume 20, Issue 6, Page(s) 929–934

    Abstract: Aims: Progression of atrial fibrillation (AF) from paroxysmal to persistent forms is an active field of research. The influence of AF progression on health related quality of life (HRQoL) is currently unknown. We aimed to assess the influence of AF ... ...

    Abstract Aims: Progression of atrial fibrillation (AF) from paroxysmal to persistent forms is an active field of research. The influence of AF progression on health related quality of life (HRQoL) is currently unknown. We aimed to assess the influence of AF progression on HRQoL, and whether this association is mediated through symptoms, treatment, and major adverse events.
    Methods and results: In the Euro Heart Survey, 967 patients were included with paroxysmal AF who filled out EuroQoL-5D at baseline and at 1 year follow-up. Those who progressed (n = 132, 13.6%) developed more problems during follow-up than those who did not, on all EuroQoL-5D domains (increase in problems on mobility 20.5% vs. 11.4%; self-care 12.9% vs. 6.2%; usual activities 23.5% vs. 14.0%; pain/discomfort 20.5% vs. 13.7%; and anxiety/depression 22.7% vs. 15.7%; all P < 0.05), leading to a decrease in utility [baseline 0.744 ± 0.26, follow-up 0.674 ± 0.36; difference -0.07 (95% CI [-0.126,-0.013], P = 0.02)]. Multivariate analysis showed that the effect of progression on utility is mediated by a large effect of adverse events [stroke (-0.27 (95% CI [-0.43,-0.11]); P = 0.001], heart failure [-0.12 (95% CI [-0.20,-0.05]); P = 0.001], malignancy (-0.31 (95% CI [-0.56,-0.05]); P = 0.02] or implantation of an implantable cardiac defibrillator [-0.12 (95% CI [-0.23,-0.02]); P = 0.03)], as well as symptomatic AF [-0.04 (95% CI [-0.08,-0.01]); P = 0.008].
    Conclusion: AF progression is associated with a decrease in HRQoL. However, multivariate analysis revealed that AF progression itself does not have a negative effect on HRQoL, but that this effect can be attributed to a minor effect of the associated symptoms and a major effect of associated adverse events.
    MeSH term(s) Age Factors ; Aged ; Atrial Fibrillation/epidemiology ; Atrial Fibrillation/physiopathology ; Atrial Fibrillation/psychology ; Atrial Fibrillation/therapy ; Defibrillators, Implantable/psychology ; Defibrillators, Implantable/statistics & numerical data ; Disease Progression ; Europe/epidemiology ; Female ; Health Surveys ; Heart Failure/etiology ; Heart Failure/psychology ; Humans ; Long Term Adverse Effects/etiology ; Long Term Adverse Effects/psychology ; Male ; Middle Aged ; Quality of Life ; Risk Assessment ; Risk Factors ; Stroke/etiology ; Stroke/psychology
    Language English
    Publishing date 2017-11-17
    Publishing country England
    Document type Journal Article
    ZDB-ID 1449879-0
    ISSN 1532-2092 ; 1099-5129
    ISSN (online) 1532-2092
    ISSN 1099-5129
    DOI 10.1093/europace/eux217
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  7. Article ; Online: The mechanical fibrillation pattern of the atrial myocardium is associated with acute and long-term success of electrical cardioversion in patients with persistent atrial fibrillation.

    De Vos, Cees B / Limantoro, Ione / Pisters, Ron / Delhaas, Tammo / Schotten, Ulrich / Cheriex, Emile C / Tieleman, Robert G / Crijns, Harry J G M

    Heart rhythm

    2014  Volume 11, Issue 9, Page(s) 1514–1521

    Abstract: Background: Electrophysiological studies demonstrate that a short atrial fibrillation cycle length (AFCL) is related with poor outcome of electrical cardioversion (ECV) of atrial fibrillation (AF). We found previously that the mechanical AFCL (AFCL-tvi) ...

    Abstract Background: Electrophysiological studies demonstrate that a short atrial fibrillation cycle length (AFCL) is related with poor outcome of electrical cardioversion (ECV) of atrial fibrillation (AF). We found previously that the mechanical AFCL (AFCL-tvi) and atrial fibrillatory velocity (AFV-tvi) may be determined noninvasively using color tissue velocity imaging (TVI) and closely relates to the electrophysiological AFCL.
    Objective: To evaluate the relation between AFCL-tvi, AFV-tvi, and success of ECV in patients with AF.
    Methods: We prospectively studied 133 patients with persistent AF by performing echocardiography before ECV and measured the AFCL-tvi and AFV-tvi in the right atrium and left atrium. Recurrent AF was monitored.
    Results: Nineteen (14%) patients had failure of ECV, 42 (32%) remained in sinus rhythm after 1-year follow-up, and 72 (54%) had a recurrence of persistent AF. Patients with immediate ECV failure had a lower median AFV-tvi measured in the right atrium than did patients with a successful ECV: 0.7 cm/s (0.2-1.0 cm/s) vs. 1.7 cm/s (0.9-2.8 cm/s) (P = .008). Patients with maintenance of sinus rhythm after 1 year had a longer AFCL-tvi measured in the left atrium than did patients with recurrence of AF (150 ms vs 137 ms; P = .017) and had a higher AFV-tvi in both atria (1.4 vs. 0.9 cm/s in the left atrium; P = .013 and 2.2 vs 1.4 cm/s in the right atrium; P = .011). Multivariate analyses showed that all atrial TVI parameters were independently associated with the maintenance of sinus rhythm after 1 year.
    Conclusion: Higher atrial fibrillatory wall velocities and longer AFCLs determined by echocardiography are associated with acute and long-term success of ECV.
    MeSH term(s) Aged ; Atrial Fibrillation/physiopathology ; Atrial Fibrillation/therapy ; Echocardiography ; Electric Countershock/methods ; Electrocardiography ; Female ; Follow-Up Studies ; Heart Atria/diagnostic imaging ; Heart Atria/physiopathology ; Heart Conduction System/physiopathology ; Heart Rate/physiology ; Humans ; Male ; Middle Aged ; Prognosis ; Prospective Studies ; Time Factors
    Language English
    Publishing date 2014-09
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2229357-7
    ISSN 1556-3871 ; 1547-5271
    ISSN (online) 1556-3871
    ISSN 1547-5271
    DOI 10.1016/j.hrthm.2014.04.029
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  8. Article ; Online: Poor anticoagulation relates to extended access times for cardioversion and is associated with long-term major cardiac and cerebrovascular events.

    Erküner, Ömer / Claessen, Roy / Pisters, Ron / Schulmer, Germaine / Ramaekers, Roos / Sonneveld, Laura / Dudink, Elton / Lankveld, Theo / Limantoro, Ione / Weijs, Bob / Pison, Laurent / Blaauw, Yuri / de Vos, Cees B / Crijns, Harry Jgm

    International journal of cardiology

    2016  Volume 225, Page(s) 337–341

    Abstract: Background: Patients undergoing elective electrical cardioversion (ECV) for atrial fibrillation have a temporarily increased risk of thromboembolism. Current guidelines recommend adequate anticoagulation for ≥3 consecutive weeks precardioversion, i.e. ... ...

    Abstract Background: Patients undergoing elective electrical cardioversion (ECV) for atrial fibrillation have a temporarily increased risk of thromboembolism. Current guidelines recommend adequate anticoagulation for ≥3 consecutive weeks precardioversion, i.e. consecutive INR values 2.0-3.0 in patients with vitamin K antagonists (VKA). We aimed to evaluate the occurrence and impact of subtherapeutic INRs precardioversion and to study factors associated with these unwanted fluctuations.
    Methods: We recruited 346 consecutive patients undergoing elective ECV in the Maastricht University Medical Centre between 2008 and 2013. Predictors of subtherapeutic INR values were identified and incorporated into a logistic regression model.
    Results: A subtherapeutic INR precardioversion occurred in 55.2% of patients. The only statistically significant predictor was VKA-naivety (Odds Ratio (OR) 4.78, 95% Confidence Interval (CI) 2.67-8.58, p<0.001). In patients with ≥1 subtherapeutic INR precardioversion, time from referral until cardioversion was 91.1±42.8days, compared to 41.7±26.6days (p<0.001) in patients without subtherapeutic INRs. No thromboembolic events occurred <30days after the ECV. Independent predictors for the combined endpoint of cardiovascular death, ischemic stroke and the need of blood transfusion (n=30, median follow-up of 374days) were coronary artery disease in the history (OR 3.35, 95%CI 1.54-7.25, p=0.002) and subtherapeutic INR precardioversion (OR 3.64, 95%CI 1.43-9.24, p=0.007).
    Conclusions: The use of VKA often results in subtherapeutic INRs precardioversion and is associated with a significant delay until cardioversion, especially in patients with recent initiation of VKA therapy. Furthermore, subtherapeutic INR levels prior to ECV are associated with the combined endpoint of cardiovascular death, ischemic stroke and the need of blood transfusion.
    MeSH term(s) Aged ; Anticoagulants/administration & dosage ; Cerebrovascular Disorders/blood ; Cerebrovascular Disorders/epidemiology ; Cerebrovascular Disorders/therapy ; Cohort Studies ; Electric Countershock/methods ; Electric Countershock/trends ; Female ; Follow-Up Studies ; Heart Diseases/blood ; Heart Diseases/epidemiology ; Heart Diseases/therapy ; Humans ; International Normalized Ratio/trends ; Male ; Middle Aged ; Netherlands/epidemiology ; Prospective Studies ; Registries ; Time Factors ; Vitamin K/antagonists & inhibitors
    Chemical Substances Anticoagulants ; Vitamin K (12001-79-5)
    Language English
    Publishing date 2016-12-15
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 779519-1
    ISSN 1874-1754 ; 0167-5273
    ISSN (online) 1874-1754
    ISSN 0167-5273
    DOI 10.1016/j.ijcard.2016.10.018
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  9. Article ; Online: Use and underuse of oral anticoagulation for stroke prevention in atrial fibrillation: old and new paradigms.

    Pisters, Ron / de Vos, Cees B / Nieuwlaat, Robby / Crijns, Harry J G M

    Seminars in thrombosis and hemostasis

    2009  Volume 35, Issue 6, Page(s) 554–559

    Abstract: Atrial fibrillation (AF) is the most common sustained arrhythmia of the Western world. The increased ischemic stroke risk of the AF patient is one of the most important clinical issues to manage. Despite the well-known benefit of oral anticoagulation in ... ...

    Abstract Atrial fibrillation (AF) is the most common sustained arrhythmia of the Western world. The increased ischemic stroke risk of the AF patient is one of the most important clinical issues to manage. Despite the well-known benefit of oral anticoagulation in high-risk AF patients, these drugs are widely underused in daily practice all over the world. We describe old and new paradigms of the use of oral anticoagulation. In the future, increased comprehensibility of stroke risk scores, development of a validated clinical bleed risk score, and new patient and physician user-friendly antithrombotic medication may contribute to improved adequate use of oral anticoagulation in AF patients.
    MeSH term(s) Administration, Oral ; Anticoagulants/adverse effects ; Anticoagulants/therapeutic use ; Atrial Fibrillation/drug therapy ; Guideline Adherence ; Humans ; Practice Guidelines as Topic ; Stroke/drug therapy ; Stroke/prevention & control ; Treatment Outcome
    Chemical Substances Anticoagulants
    Language English
    Publishing date 2009-09
    Publishing country United States
    Document type Journal Article
    ZDB-ID 196901-8
    ISSN 1098-9064 ; 0094-6176
    ISSN (online) 1098-9064
    ISSN 0094-6176
    DOI 10.1055/s-0029-1241048
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  10. Article ; Online: Clinical and echocardiographic correlates of intra-atrial conduction delay.

    Weijs, Bob / de Vos, Cees B / Tieleman, Robert G / Pisters, Ron / Cheriex, Emile C / Prins, Martin H / Crijns, Harry J G M

    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

    2011  Volume 13, Issue 12, Page(s) 1681–1687

    Abstract: ... that atrial fibrillation (AF) in history (B = 9.7; 95%CI 5.7-13.8; P < 0.001), hypertension (B = 5.5; 95%CI 1.4-9.8; P = 0 ... 01), clinically relevant valve disease (B = 5.7; 95%CI 0.5-10.8; P = 0.03), age (B = 5; 95%CI 3.3-6.6 ... P < 0.001), and body mass index (BMI; B = 2.6; 95%CI 0.3-4.9; P = 0.026) were independently ...

    Abstract Aims: The total atrial conduction time (TACT) is an important electrophysiological parameter. We developed a new transthoracic echocardiographic tool (PA-TDI). The PA-TDI interval is a reflection of the TACT. In the present study, we evaluated the clinical and echocardiographic correlates of intra-atrial conduction delay.
    Methods and results: We studied 427 patients without class I anti-arrhythmic agents or amiodarone. All patients underwent an echocardiogram and the PA-TDI interval was measured. Patient characteristics were recorded. The mean PA-TDI was 157 ± 22 ms. Multivariate linear regression analysis revealed that atrial fibrillation (AF) in history (B = 9.7; 95%CI 5.7-13.8; P < 0.001), hypertension (B = 5.5; 95%CI 1.4-9.8; P = 0.01), clinically relevant valve disease (B = 5.7; 95%CI 0.5-10.8; P = 0.03), age (B = 5; 95%CI 3.3-6.6; P < 0.001), and body mass index (BMI; B = 2.6; 95%CI 0.3-4.9; P = 0.026) were independently associated with the PA-TDI interval. On the echocardiogram: the aortic diameter (B = 0.7; 95%CI 0.2-1.2; P = 0.009), left atrial dimension (B = 0.9; 95%CI 0.5-1.3; P < 0.001), mitral valve E-wave deceleration time (B = 0.1; 95%CI 0.1-0.1; P < 0.001), aortic incompetence (B = 13; 95%CI 3.3-22.6; P = 0.008), and mitral incompetence (B = 11; 95%CI 3.6-17.5; P < 0.003) were independently associated with the PA-TDI interval.
    Conclusion: This study is the largest to investigate the relation between the atrial conduction time, underlying heart diseases, and echocardiographic parameters. We found that the PA-TDI was independently prolonged in patients with a history of AF, hypertension, valve disease, higher age, and a higher BMI. Signs of diastolic dysfunction, valve incompetence, and enlarged atrium or aortic root on the echocardiogram were associated with a prolonged PA-TDI. This suggests that early and aggressive treatment of hypertension, diastolic dysfunction, and obesity could prevent intra-atrial conduction delay.
    MeSH term(s) Aged ; Atrial Fibrillation/diagnostic imaging ; Atrial Fibrillation/physiopathology ; Echocardiography/methods ; Female ; Heart Atria/diagnostic imaging ; Heart Atria/physiopathology ; Heart Conduction System/diagnostic imaging ; Heart Conduction System/physiopathology ; Heart Valve Diseases/diagnostic imaging ; Heart Valve Diseases/physiopathology ; Humans ; Hypertension/diagnostic imaging ; Hypertension/physiopathology ; Linear Models ; Male ; Middle Aged ; Obesity/diagnostic imaging ; Obesity/physiopathology ; Retrospective Studies ; Time Factors
    Language English
    Publishing date 2011-12
    Publishing country England
    Document type Evaluation Studies ; Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 1449879-0
    ISSN 1532-2092 ; 1099-5129
    ISSN (online) 1532-2092
    ISSN 1099-5129
    DOI 10.1093/europace/eur261
    Database MEDical Literature Analysis and Retrieval System OnLINE

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