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  1. Article ; Online: Atrial fibrillation: better symptom control with rate and rhythm management.

    Gupta, Dhiraj / Rienstra, Michiel / van Gelder, Isabelle C / Fauchier, Laurent

    The Lancet regional health. Europe

    2024  Volume 37, Page(s) 100801

    Abstract: Atrial fibrillation (AF) is often associated with limiting symptoms, and with significant impairment in quality of life. As such, treatment strategies aimed at symptom control form an important pillar of AF management. Such treatments include a wide ... ...

    Abstract Atrial fibrillation (AF) is often associated with limiting symptoms, and with significant impairment in quality of life. As such, treatment strategies aimed at symptom control form an important pillar of AF management. Such treatments include a wide variety of drugs and interventions, including, increasingly, catheter ablation. These strategies can be utilised either singly or in combination, to improve and restore quality of life for patients, and this review covers the current evidence base underpinning their use. In this Review, we discuss the pros and cons of rate vs. rhythm control, while offering practical tips to non-specialists on how to utilise various treatments and counsel patients about all relevant treatment options. These include antiarrhythmic and rate control medications, as well as interventions such as cardioversion, catheter ablation, and pace-and-ablate.
    Language English
    Publishing date 2024-02-01
    Publishing country England
    Document type Journal Article ; Review
    ISSN 2666-7762
    ISSN (online) 2666-7762
    DOI 10.1016/j.lanepe.2023.100801
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  2. Article: Multimorbidity in patients with atrial fibrillation.

    Lobeek, Michelle / Middeldorp, Melissa E / Van Gelder, Isabelle C / Rienstra, Michiel

    Open heart

    2024  Volume 11, Issue 1

    Abstract: There is an escalating trend in both the incidence and prevalence of atrial fibrillation (AF). AF is linked to numerous other comorbidities, contributing to the emergence of multimorbidity. The sustained rise in multimorbidity and AF prevalences exerts a ...

    Abstract There is an escalating trend in both the incidence and prevalence of atrial fibrillation (AF). AF is linked to numerous other comorbidities, contributing to the emergence of multimorbidity. The sustained rise in multimorbidity and AF prevalences exerts a significant strain on healthcare systems globally. The understanding of the relation between multimorbidity and AF is essential to determine effective healthcare strategies, improve patient outcomes to adequately address the burden of AF. It not only begins with the accurate identification of comorbidities in the setting of AF. There is also the need to understand the pathophysiology of the different comorbidities and their common interactions, and how multimorbidity influences AF perpetuation. To manage the challenges that rise from the increasing incidence and prevalence of both multimorbidity and AF, such as adverse events and hospitalisations, the treatment of comorbidities in AF has already gained importance and will need to be a primary focus in the forthcoming years. There are numerous challenges to overcome in the treatment of multimorbidity in AF, whereby the identification of comorbidities is essential. Integrated care strategies focused on a comprehensive multimorbidity management with an individual-centred approach need to be determined to improve healthcare strategies and reduce the AF-related risk of frailty, cardiovascular diseases and improve patient outcomes.
    MeSH term(s) Humans ; Atrial Fibrillation/diagnosis ; Atrial Fibrillation/epidemiology ; Atrial Fibrillation/therapy ; Multimorbidity ; Comorbidity ; Hospitalization ; Frailty
    Language English
    Publishing date 2024-03-19
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 2747269-3
    ISSN 2053-3624
    ISSN 2053-3624
    DOI 10.1136/openhrt-2024-002641
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  3. Article ; Online: Author Correction: Epidemiology and modifiable risk factors for atrial fibrillation.

    Elliott, Adrian D / Middeldorp, Melissa E / Van Gelder, Isabelle C / Albert, Christine M / Sanders, Prashanthan

    Nature reviews. Cardiology

    2023  Volume 20, Issue 6, Page(s) 429

    Language English
    Publishing date 2023-01-03
    Publishing country England
    Document type Published Erratum
    ZDB-ID 2490375-9
    ISSN 1759-5010 ; 1759-5002
    ISSN (online) 1759-5010
    ISSN 1759-5002
    DOI 10.1038/s41569-023-00834-w
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  4. Article ; Online: Incidence and outcome of atrial fibrillation: diversity throughout Europe.

    Rienstra, Michiel / Van Gelder, Isabelle C

    European heart journal

    2021  Volume 42, Issue 8, Page(s) 858–860

    MeSH term(s) Atrial Fibrillation/epidemiology ; Europe/epidemiology ; Humans ; Incidence ; Socioeconomic Factors ; Stroke
    Language English
    Publishing date 2021-01-25
    Publishing country England
    Document type Editorial ; Comment
    ZDB-ID 603098-1
    ISSN 1522-9645 ; 0195-668X
    ISSN (online) 1522-9645
    ISSN 0195-668X
    DOI 10.1093/eurheartj/ehaa1078
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  5. Article ; Online: Atrial fibrillation and heart failure temporality: does it matter?

    Van Deutekom, Colinda / Van Gelder, Isabelle C / Rienstra, Michiel

    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

    2022  Volume 25, Issue 2, Page(s) 247–248

    MeSH term(s) Humans ; Atrial Fibrillation/complications ; Atrial Fibrillation/diagnosis ; Atrial Fibrillation/epidemiology ; Heart Failure/complications ; Heart Failure/diagnosis ; Heart Failure/therapy
    Language English
    Publishing date 2022-12-24
    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/euac255
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  6. Article ; Online: ESC and EHRA lead a path towards integrated care for multimorbid atrial fibrillation patients: the Horizon 2020 EHRA-PATHS project.

    Heidbuchel, Hein / Van Gelder, Isabelle C / Desteghe, Lien

    European heart journal

    2021  Volume 43, Issue 15, Page(s) 1450–1452

    MeSH term(s) Anticoagulants ; Atrial Fibrillation/therapy ; Delivery of Health Care, Integrated ; Humans ; Thromboembolism
    Chemical Substances Anticoagulants
    Language English
    Publishing date 2021-10-25
    Publishing country England
    Document type Journal Article
    ZDB-ID 603098-1
    ISSN 1522-9645 ; 0195-668X
    ISSN (online) 1522-9645
    ISSN 0195-668X
    DOI 10.1093/eurheartj/ehab672
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  7. Article ; Online: The road goes ever on: innovations and paradigm shifts in atrial fibrillation management.

    Heijman, Jordi / Vernooy, Kevin / C van Gelder, Isabelle

    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

    2021  Volume 23, Issue 23 Suppl 2, Page(s) ii1–ii3

    MeSH term(s) Anticoagulants/adverse effects ; Atrial Fibrillation/surgery ; Atrial Fibrillation/therapy ; Catheter Ablation ; Humans
    Chemical Substances Anticoagulants
    Language English
    Publishing date 2021-03-22
    Publishing country England
    Document type Editorial
    ZDB-ID 1449879-0
    ISSN 1532-2092 ; 1099-5129
    ISSN (online) 1532-2092
    ISSN 1099-5129
    DOI 10.1093/europace/euab061
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  8. Article ; Online: STEEER-AF: a cluster-randomized education trial from the ESC.

    Bunting, Karina V / Van Gelder, Isabelle C / Kotecha, Dipak

    European heart journal

    2020  Volume 41, Issue 21, Page(s) 1952–1954

    MeSH term(s) Atrial Fibrillation ; Humans ; Stroke
    Language English
    Publishing date 2020-05-25
    Publishing country England
    Document type Journal Article
    ZDB-ID 603098-1
    ISSN 1522-9645 ; 0195-668X
    ISSN (online) 1522-9645
    ISSN 0195-668X
    DOI 10.1093/eurheartj/ehaa421
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  9. Article ; Online: Epidemiology and modifiable risk factors for atrial fibrillation.

    Elliott, Adrian D / Middeldorp, Melissa E / Van Gelder, Isabelle C / Albert, Christine M / Sanders, Prashanthan

    Nature reviews. Cardiology

    2023  Volume 20, Issue 6, Page(s) 404–417

    Abstract: The global prevalence of atrial fibrillation (AF) has increased substantially over the past three decades and is currently approximately 60 million cases. Incident AF and its clinical consequences are largely the result of risk factors that can be ... ...

    Abstract The global prevalence of atrial fibrillation (AF) has increased substantially over the past three decades and is currently approximately 60 million cases. Incident AF and its clinical consequences are largely the result of risk factors that can be modified by lifestyle changes. In this Review, we provide evidence that the lifetime risk of AF is modified not only by sex and race but also through the clinical risk factor and comorbidity burden of individual patients. We begin by summarizing the epidemiology of AF, focusing on non-modifiable and modifiable risk factors, as well as targets and strategies for the primary prevention of AF. Furthermore, we evaluate the role of modifiable risk factors in the secondary prevention of AF as well as the potential effects of risk factor interventions on the frequency and severity of subsequent AF episodes. We end the Review by proposing strategies that require evaluation as well as global policy changes that are needed for the prevention of incident AF and the management of recurrent episodes in patients already affected by AF.
    MeSH term(s) Humans ; Atrial Fibrillation/epidemiology ; Risk Factors ; Comorbidity ; Life Style
    Language English
    Publishing date 2023-01-04
    Publishing country England
    Document type Journal Article ; Review ; Research Support, Non-U.S. Gov't
    ZDB-ID 2490375-9
    ISSN 1759-5010 ; 1759-5002
    ISSN (online) 1759-5010
    ISSN 1759-5002
    DOI 10.1038/s41569-022-00820-8
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  10. Article ; Online: Rate control in atrial fibrillation, calcium channel blockers versus beta-blockers.

    Koldenhof, Tim / Van Gelder, Isabelle C / Crijns, Harry Jgm / Rienstra, Michiel / Tieleman, Robert G

    Heart (British Cardiac Society)

    2023  Volume 109, Issue 23, Page(s) 1759–1764

    Abstract: Objective: To investigate heart rate differences between non-dihydropyridine calcium channel blockers and beta-blockers in patients with non-permanent atrial fibrillation (AF).: Methods: Using data from 'A Comparison of Rate Control and Rhythm ... ...

    Abstract Objective: To investigate heart rate differences between non-dihydropyridine calcium channel blockers and beta-blockers in patients with non-permanent atrial fibrillation (AF).
    Methods: Using data from 'A Comparison of Rate Control and Rhythm Control in Patients with Atrial Fibrillation' (AFFIRM), where patients were randomised 1:1 rate or rhythm control, we compared the effect of rate control drugs on heart rate during AF as well as during sinus rhythm. Multivariable logistic regression was used to adjust for baseline characteristics.
    Results: A total of 4060 patients were enrolled in the AFFIRM trial, mean age was 70±9 years, 39% were women. Out of the total, 1112 patients were in sinus rhythm at baseline and used either non-dihydropyridine channel blockers or beta-blockers. Of them, 474 had AF during follow-up while remaining on the same rate control drugs, 218 (46%) on calcium channel blockers and 256 (54%) on beta-blockers. Mean age of calcium channel blocker patients was 70±8 years and 68±8 for beta-blocker patients (p=0.003), 42% were women. A resting heart rate <110 beats per min during AF was achieved in 92% of patients using calcium channel blockers and 92% of patients using beta-blockers (p=1.00). Bradycardia during sinus rhythm occurred in 17% of patients using calcium channel blockers vs 32% using beta-blockers (p<0.001). After adjusting for patient characteristics, calcium channel blockers were associated with a reduction in bradycardia during sinus rhythm (OR 0.41, 95% CI 0.19 to 0.90).
    Conclusion: In patients with non-permanent AF, calcium channel blockers instituted for rate control were associated with less bradycardia during sinus rhythm compared with beta-blockers.
    MeSH term(s) Humans ; Female ; Middle Aged ; Aged ; Male ; Atrial Fibrillation/complications ; Calcium Channel Blockers/therapeutic use ; Calcium Channel Blockers/pharmacology ; Bradycardia/chemically induced ; Bradycardia/complications ; Adrenergic beta-Antagonists/therapeutic use ; Adrenergic beta-Antagonists/pharmacology ; Heart Rate/physiology ; Anti-Arrhythmia Agents/therapeutic use
    Chemical Substances Calcium Channel Blockers ; Adrenergic beta-Antagonists ; Anti-Arrhythmia Agents
    Language English
    Publishing date 2023-11-10
    Publishing country England
    Document type Randomized Controlled Trial ; Journal Article
    ZDB-ID 1303417-0
    ISSN 1468-201X ; 1355-6037
    ISSN (online) 1468-201X
    ISSN 1355-6037
    DOI 10.1136/heartjnl-2023-322635
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