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  1. Article ; Online: Diagnostiek en behandeling van atriumfibrilleren.

    Tieleman, Robert G / Geersing, Geert-Jan

    Nederlands tijdschrift voor geneeskunde

    2023  Volume 167

    Abstract: For the diagnosis of atrial fibrillation, it is mandatory to make an ECG during the arrhythmia. In patients with paroxysmal atrial fibrillation this can be challenging. Consumer wearables such as smart watches with automated AF detection can be helpful ... ...

    Title translation Diagnosis and therapeutic options in atrial fibrillation.
    Abstract For the diagnosis of atrial fibrillation, it is mandatory to make an ECG during the arrhythmia. In patients with paroxysmal atrial fibrillation this can be challenging. Consumer wearables such as smart watches with automated AF detection can be helpful for diagnosing even asymptomatic AF, as long as they offer the possibility to record a one lead ECG rhythm strip. Once AF is diagnosed, therapeutic decisions, such as rate-control versus rhythm-control and start of oral anticoagulation therapy need to be made on an individual basis in each patient. The present manuscript deals with frequently asked questions encountered in daily practice of treating patients with AF.
    MeSH term(s) Humans ; Atrial Fibrillation/therapy ; Atrial Fibrillation/drug therapy ; Electrocardiography
    Language Dutch
    Publishing date 2023-06-07
    Publishing country Netherlands
    Document type English Abstract ; Journal Article
    ZDB-ID 82073-8
    ISSN 1876-8784 ; 0028-2162
    ISSN (online) 1876-8784
    ISSN 0028-2162
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  2. Article: How to tackle the unknowns in atrial fibrillation?

    Hemels, Martin E W / Tieleman, Robert G

    Netherlands heart journal : monthly journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation

    2024  Volume 32, Issue 4, Page(s) 156–159

    Language English
    Publishing date 2024-03-01
    Publishing country Netherlands
    Document type Editorial
    ZDB-ID 2211468-3
    ISSN 1876-6250 ; 1568-5888 ; 0929-7456
    ISSN (online) 1876-6250
    ISSN 1568-5888 ; 0929-7456
    DOI 10.1007/s12471-024-01865-9
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  3. Article ; Online: Atriumfibrilleren voorspellen met een sinusritme-ecg; wel of niet zinning?

    Tieleman, Robert G

    Nederlands tijdschrift voor geneeskunde

    2019  Volume 163

    Abstract: In patients with cryptogenic stroke, the detection of atrial fibrillation (AF) is important, since it is an indication for the prescription of oral anticoagulation, instead of anti-platelet therapy, to decrease the chance of a recurrent ischaemic ... ...

    Title translation Predicting atrial fibrillation through a sinus-rhythm electrocardiogram; useful or not?
    Abstract In patients with cryptogenic stroke, the detection of atrial fibrillation (AF) is important, since it is an indication for the prescription of oral anticoagulation, instead of anti-platelet therapy, to decrease the chance of a recurrent ischaemic cerebral event. The presence of permanent AF is easily detected by means of an electrocardiogram (ECG). However, in paroxysmal AF patients, expensive long-term rhythm monitoring might be necessary to detect the arrhythmia. In the present article, the authors describe an algorithm, constructed by artificial intelligence and big data, to detect a 'footprint' of AF on a 12-lead ECG during sinus rhythm. However, despite this promising premise, the algorithm comes from a 'black-box' calculation and, therefore, it cannot rule out possible bias from medication or patient characteristics. Furthermore, the combination of a moderate test specificity and a low prevalence of only 10% undetected AF in the post-stroke population, results in a low positive predictive value, which is not useful for initiation of anticoagulation therapy.
    MeSH term(s) Algorithms ; Anticoagulants/therapeutic use ; Artificial Intelligence ; Atrial Fibrillation/complications ; Atrial Fibrillation/diagnosis ; Atrial Fibrillation/drug therapy ; Decision Support Techniques ; Electrocardiography/methods ; Humans ; Predictive Value of Tests ; Reproducibility of Results ; Stroke/etiology ; Stroke/prevention & control
    Chemical Substances Anticoagulants
    Language Dutch
    Publishing date 2019-11-28
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 82073-8
    ISSN 1876-8784 ; 0028-2162
    ISSN (online) 1876-8784
    ISSN 0028-2162
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  4. Article ; Online: Wordt de trombosedienst een DOAC-dienst?

    Tieleman, Robert G

    Nederlands tijdschrift voor geneeskunde

    2018  Volume 162

    Abstract: In the Netherlands, a well-organized network of anticoagulation centres has been managing anticoagulation with vitamin K antagonists for the last 60-70 years. The introduction of direct oral anticoagulant (DOAC) therapy has made treatment much more ... ...

    Title translation Will anticoagulation centres become a DOAC service?
    Abstract In the Netherlands, a well-organized network of anticoagulation centres has been managing anticoagulation with vitamin K antagonists for the last 60-70 years. The introduction of direct oral anticoagulant (DOAC) therapy has made treatment much more straightforward and it can now be managed by a general physician or a nurse specialized in cardiovascular risk management. The involvement of the current anticoagulation centres in anticoagulation therapy will accordingly become smaller over time, as more patients will be treated with DOACs, and anticoagulation centres in their present form may no longer be needed.
    MeSH term(s) Administration, Oral ; Ambulatory Care Facilities/trends ; Anticoagulants/therapeutic use ; Fibrinolytic Agents/therapeutic use ; Humans ; Netherlands ; Thrombolytic Therapy/trends
    Chemical Substances Anticoagulants ; Fibrinolytic Agents
    Language Dutch
    Publishing date 2018-11-30
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 82073-8
    ISSN 1876-8784 ; 0028-2162
    ISSN (online) 1876-8784
    ISSN 0028-2162
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  5. Article ; Online: Early atrial fibrillation detection and the transition to comprehensive management.

    Linz, Dominik / Hermans, Astrid / Tieleman, Robert G

    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) ii46–ii51

    Abstract: Current atrial fibrillation (AF) guidelines recommend screening for AF in individuals above 65 years or with other characteristics suggestive of increased stroke risk. Several mobile health (mHealth) approaches are available to identify AF. Although most ...

    Abstract Current atrial fibrillation (AF) guidelines recommend screening for AF in individuals above 65 years or with other characteristics suggestive of increased stroke risk. Several mobile health (mHealth) approaches are available to identify AF. Although most wearables or ECG machines include algorithms to detect AF, an ECG confirmation of AF is necessary to establish a suspected diagnosis of AF. Early detection of AF is important to allow early initiation of AF management, and early rhythm control therapy lowered risk of adverse cardiovascular outcomes among patients with early AF aged >75 or with a CHA2DS2-VASc score ≥2 and cardiovascular conditions in the EAST-AFNET 4 study. Strategies for early AF detection should be always linked to a comprehensive work-up infrastructure organized within an integrated care pathway to allow early initiation and guidance of AF treatment in newly detected AF patients. In this review article, we summarize strategies and mHealth approaches for early AF detection and the transition to early AF management including AF symptoms evaluation and assessment of AF progression as well as AF risk factors.
    MeSH term(s) Atrial Fibrillation/diagnosis ; Atrial Fibrillation/therapy ; Electrocardiography ; Humans ; Risk Assessment ; Risk Factors ; Stroke ; Telemedicine
    Language English
    Publishing date 2021-03-22
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 1449879-0
    ISSN 1532-2092 ; 1099-5129
    ISSN (online) 1532-2092
    ISSN 1099-5129
    DOI 10.1093/europace/euaa424
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  6. 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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  7. Article ; Online: Obey the first recommendation: start screening programmes for atrial fibrillation.

    Tieleman, Robert G / Hemels, Martin E

    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

    2016  Volume 18, Issue 12, Page(s) 1753–1755

    MeSH term(s) Atrial Fibrillation ; Cardiovascular Diseases ; Electrocardiography ; Humans ; Stroke/prevention & control
    Language English
    Publishing date 2016
    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/euw160
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  8. Article ; Online: Letter responding to Screening for atrial fibrillation: a European Heart Rhythm Association (EHRA) consensus document endorsed by the Heart Rhythm Society (HRS), Asia Pacific Heart Rhythm Society (APHRS), and Societad Latinoamericana de Estimulation Cardiaca y Electrofisiologia (SOLAECE).

    Jacobs, Maartje S / van Hulst, Marinus / Tieleman, Robert G

    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

    2018  Volume 20, Issue 5, Page(s) 893

    MeSH term(s) Asia ; Atrial Fibrillation ; Cardiology ; Consensus ; Humans
    Language English
    Publishing date 2018-04-20
    Publishing country England
    Document type Letter ; Comment
    ZDB-ID 1449879-0
    ISSN 1532-2092 ; 1099-5129
    ISSN (online) 1532-2092
    ISSN 1099-5129
    DOI 10.1093/europace/euy008
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  9. Article ; Online: Correction: Cost-effectiveness of apixaban compared to other anticoagulants in patients with atrial fibrillation in the real-world and trial settings.

    de Jong, Lisa A / Groeneveld, Jessie / Stevanovic, Jelena / Rila, Harrie / Tieleman, Robert G / Huisman, Menno V / Postma, Maarten J / van Hulst, Marinus

    PloS one

    2022  Volume 17, Issue 3, Page(s) e0266625

    Abstract: This corrects the article DOI: 10.1371/journal.pone.0222658.]. ...

    Abstract [This corrects the article DOI: 10.1371/journal.pone.0222658.].
    Language English
    Publishing date 2022-03-31
    Publishing country United States
    Document type Published Erratum
    ZDB-ID 2267670-3
    ISSN 1932-6203 ; 1932-6203
    ISSN (online) 1932-6203
    ISSN 1932-6203
    DOI 10.1371/journal.pone.0266625
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  10. Article: Prevalence and Incidence of Atrial Fibrillation in Heart Failure with Mildly Reduced or Preserved Ejection Fraction: (Additive) Value of Implantable Loop Recorders.

    Gorter, Thomas M / van Veldhuisen, Dirk J / Mulder, Bart A / Artola Arita, Vicente A / van Empel, Vanessa P M / Manintveld, Olivier C / Tieleman, Robert G / Maass, Alexander H / Vernooy, Kevin / van Gelder, Isabelle C / Rienstra, Michiel

    Journal of clinical medicine

    2023  Volume 12, Issue 11

    Abstract: Background: Atrial fibrillation (AF) is common in heart failure with mildly reduced or preserved ejection fraction (HFmrEF/HFpEF) and has a negative impact on outcome. Reliable data on prevalence, incidence, and detection of AF from contemporary, ... ...

    Abstract Background: Atrial fibrillation (AF) is common in heart failure with mildly reduced or preserved ejection fraction (HFmrEF/HFpEF) and has a negative impact on outcome. Reliable data on prevalence, incidence, and detection of AF from contemporary, prospective HFmrEF/HFpEF studies are scarce.
    Methods: This was a prespecified sub-analysis from a prospective, multicenter study. Patients with HFmrEF/HFpEF underwent 12-lead electrocardiography (ECG), 24 h Holter monitoring, and received an implantable loop recorder (ILR) at the study start. During the 2 year follow-up, rhythm monitoring was performed via ILR, yearly ECG, and two yearly 24 h Holter monitors.
    Results: A total of 113 patients were included (mean age 73 ± 8 years, 75% HFpEF). At baseline, 70 patients (62%) had a diagnosis of AF: 21 paroxysmal, 18 persistent, and 31 permanent AF. At study start, 45 patients were in AF. Of the 43 patients without a history of AF, 19 developed incident AF during a median follow-up of 23 [15-25] months (44%; incidence rate 27.1 (95% confidence interval 16.3-42.4) per 100 person-years). Thus, after the 2-year follow-up, 89 patients (79%) had a diagnosis of AF. In 11/19 incident AF cases (i.e., 58%), AF was solely detected on the ILR. Yearly 12-lead ECG detected six incident AF cases and four of these cases were also detected on two yearly 24 h Holter monitors. Two incident AF cases were detected on an unplanned ECG/Holter.
    Conclusions: Atrial fibrillation is extremely common in heart failure with HFmrEF/HFpEF and may inform on symptom evaluation and treatment options. AF screening with an ILR had a much higher diagnostic yield than conventional modalities.
    Language English
    Publishing date 2023-05-26
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2662592-1
    ISSN 2077-0383
    ISSN 2077-0383
    DOI 10.3390/jcm12113682
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