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A Clinical Perspective on Atrial Fibrillation

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Atrial Fibrillation from an Engineering Perspective

Part of the book series: Series in BioEngineering ((SERBIOENG))

Abstract

Atrial fibrillation is the most common arrhythmia encountered in clinical practice which requires therapeutic interventions. It severely affects the quality of life and is also one of the most common risk factors of ischemic stroke, which may lead to irreversible handicap and death. This chapter provides an overview of the current understanding of mechanism underlying the arrhythmia, its clinical manifestations, and principles of risk stratification and management. The chapter specifically addresses electrocardiographic manifestations of atrial fibrillation and outlines the challenges when using computer-based arrhythmia characteristics as biomarkers in decision-making regarding the selection of therapy or assessment prognosis.

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References

  1. J.G. Smith, P.G. Platonov, B. Hedblad, G. Engström, O. Melander, Atrial fibrillation in the Malmö Diet and Cancer study: a study of occurrence, risk factors and diagnostic validity. Eur. J. Epidemiol. 25, 95–102 (2010)

    Article  Google Scholar 

  2. P. Doliwa Sobocinski, E. Anggårdh Rooth, V. Frykman Kull, M. von Arbin, H. Wallén, M. Rosenqvist, Improved screening for silent atrial fibrillation after ischaemic stroke. Europace 14, 1112–1116 (2012)

    Article  Google Scholar 

  3. P.A. Wolf, E.J. Benjamin, A.J. Belanger, W.B. Kannel, D. Levy, R.B. D’Agostino, Secular trends in the prevalence of atrial fibrillation: the Framingham study. Am. Heart J. 131, 790–795 (1996)

    Article  Google Scholar 

  4. D.D. McManus, M. Rienstra, E.J. Benjamin, An update on the prognosis of patients with atrial fibrillation. Circulation 126, e143–146 (2012)

    Article  Google Scholar 

  5. D.M. Lloyd-Jones, T.J. Wang, E.P. Leip, M.G. Larson, D. Levy, R.S. Vasan, R.B. D’Agostino, J.M. Massaro, A. Beiser, P.A. Wolf, E.J. Benjamin, Lifetime risk for development of atrial fibrillation: the Framingham Heart study. Circulation 110, 1042–1046 (2004)

    Article  Google Scholar 

  6. P. Kirchhof, G. Breithardt, E. Aliot, S. Al Khatib, S. Apostolakis, A. Auricchio, C. Bailleul, J. Bax, G. Benninger, C. Blomström-Lundqvist, L. Boersma, G. Boriani, A. Brandes, H. Brown, M. Brueckmann, H. Calkins, B. Casadei, A. Clemens, H. Crijns, R. Derwand, D. Dobrev, M. Ezekowitz, T. Fetsch, A. Gerth, A. Gillis, M. Gulizia, G. Hack, L. Haegeli, S. Hatem, K.G. Häusler, H. Heidbüchel, J. Hernandez-Brichis, P. Jais, L. Kappenberger, J. Kautzner, S. Kim, K.-H. Kuck, D. Lane, A. Leute, T. Lewalter, R. Meyer, L. Mont, G. Moses, M. Mueller, F. Münzel, M. Näbauer, J.C. Nielsen, M. Oeff, A. Oto, B. Pieske, R. Pisters, T. Potpara, L. Rasmussen, U. Ravens, J. Reiffel, I. Richard-Lordereau, H. Schäfer, U. Schotten, W. Stegink, K. Stein, G. Steinbeck, L. Szumowski, L. Tavazzi, S. Themistoclakis, K. Thomitzek, I.C. Van Gelder, B. von Stritzky, A. Vincent, D. Werring, S. Willems, G.Y.H. Lip, A.J. Camm, Personalized management of atrial fibrillation: proceedings from the fourth Atrial Fibrillation competence NETwork/European Heart Rhythm Association consensus conference. Europace 15, 1540–1556 (2013)

    Article  Google Scholar 

  7. M. Haïssaguerre, P. Jaïs, D.C. Shah, L. Gencel, V. Pradeau, S. Garrigues, S. Chouairi, M. Hocini, P. Le Métayer, R. Roudaut, J.C.J., Right and left atrial radiofrequency catheter therapy of paroxysmal atrial fibrillation. J. Cardiovasc. Electrophysiol. 7, 1132–1144 (1996)

    Article  Google Scholar 

  8. M. Hocini, S.Y. Ho, T. Kawara, A.C. Linnenbank, M. Potse, D. Shah, P. Jaïs, M.J. Janse, M. Haïssaguerre, J.M.T. De Bakker, Electrical conduction in canine pulmonary veins: electrophysiological and anatomic correlation. Circulation 105, 2442–2448 (2002)

    Article  Google Scholar 

  9. L. Staerk, J.A. Sherer, D. Ko, E.J. Benjamin, R.H. Helm, Atrial fibrillation: epidemiology, pathophysiology, and clinical outcomes. Circ. Res. 120, 1501–1517 (2017)

    Article  Google Scholar 

  10. H. Kottkamp, Fibrotic atrial cardiomyopathy: a specific disease/syndrome supplying substrates for atrial fibrillation, atrial tachycardia, sinus node disease, AV node disease, and thromboembolic complications. J. Cardiovasc. Electrophysiol. 23, 797–799 (2012)

    Article  Google Scholar 

  11. A. Frustaci, M. Caldarulo, A. Buffon, F. Bellocci, R. Fenici, D. Melina, Cardiac biopsy in patients with ‘primary’ atrial fibrillation. Histologic evidence of occult myocardial diseases. Chest 100, 303–306 (1991)

    Article  Google Scholar 

  12. J.G. Smith, C. Newton-Cheh, P. Almgren, J. Struck, N.G. Morgenthaler, A. Bergmann, P.G. Platonov, B. Hedblad, G. Engström, T.J. Wang, O. Melander, Assessment of conventional cardiovascular risk factors and multiple biomarkers for the prediction of incident heart failure and atrial fibrillation. J. Amer. Coll. Card. 56, 1712–1719 (2010)

    Article  Google Scholar 

  13. F. Gramley, J. Lorenzen, C. Knackstedt, O.R. Rana, E. Saygili, D. Frechen, S. Stanzel, F. Pezzella, E. Koellensperger, C. Weiss, T. Münzel, P. Schauerte, Age-related atrial fibrosis. Age (Dordrecht, Netherlands) 31, 27–38 (2009)

    Article  Google Scholar 

  14. A. Frustaci, C. Chimenti, F. Bellocci, E. Morgante, M.A. Russo, A. Maseri, Histological substrate of atrial biopsies in patients with lone atrial fibrillation. Circulation 96, 1180–1184 (1997)

    Article  Google Scholar 

  15. P.G. Platonov, L.B. Mitrofanova, V. Orshanskaya, S.Y. Ho, Structural abnormalities in atrial walls are associated with presence and persistency of atrial fibrillation but not with age. J. Am. Coll. Cardiol. 58, 2225–2232 (2011)

    Article  Google Scholar 

  16. D. Corradi, S. Callegari, L. Manotti, D. Ferrara, M. Goldoni, R. Alinovi, S. Pinelli, P. Mozzoni, R. Andreoli, A. Asimaki, A. Pozzoli, G. Becchi, A. Mutti, S. Benussi, J.E. Saffitz, O. Alfieri, Persistent lone atrial fibrillation: clinicopathologic study of 19 cases. Heart Rhythm 11, 1250–1258 (2014)

    Article  Google Scholar 

  17. C. Mahnkopf, T.J. Badger, N.S. Burgon, M. Daccarett, T.S. Haslam, C.T. Badger, C.J. McGann, N. Akoum, E. Kholmovski, R.S. Macleod, N.F. Marrouche, Evaluation of the left atrial substrate in patients with lone atrial fibrillation using delayed-enhanced MRI: implications for disease progression and response to catheter ablation. Heart Rhythm 7, 1475–1481 (2010)

    Article  Google Scholar 

  18. L.B. Mitrofanova, V. Orshanskaya, S.Y. Ho, P.G. Platonov, Histological evidence of inflammatory reaction associated with fibrosis in the atrial and ventricular walls in a case-control study of patients with history of atrial fibrillation. Europace 18, iv156–iv162 (2016)

    Google Scholar 

  19. A. Boldt, U. Wetzel, J. Lauschke, J. Weigl, J. Gummert, G. Hindricks, H. Kottkamp, S. Dhein, Fibrosis in left atrial tissue of patients with atrial fibrillation with and without underlying mitral valve disease. Heart (British Cardiac Society) 90, 400–405 (2004)

    Article  Google Scholar 

  20. P. Kirchhof, S. Benussi, D. Kotecha, A. Ahlsson, D. Atar, B. Casadei, M. Castella, H.C. Diener, H. Heidbuchel, J. Hendriks, G. Hindricks, A.S. Manolis, J. Oldgren, B.A. Popescu, U. Schotten, B. Van Putte, P. Vardas, S. Agewall, J. Camm, G. Baron Esquivias, W. Budts, S. Carerj, F. Casselman, A. Coca, R. De Caterina, S. Deftereos, D. Dobrev, J.M. Ferro, G. Filippatos, D. Fitzsimons, B. Gorenek, M. Guenoun, S.H. Hohnloser, P. Kolh, G.Y. Lip, A. Manolis, J. McMurray, P. Ponikowski, R. Rosenhek, F. Ruschitzka, I. Savelieva, S. Sharma, P. Suwalski, J.L. Tamargo, C.J. Taylor, I.C. Van Gelder, A.A. Voors, S. Windecker, J.L. Zamorano, K. Zeppenfeld, 2016 ESC guidelines for the management of atrial fibrillation developed in collaboration with EACTS. Eur. Heart J. 37, 2893–2962 (2016)

    Article  Google Scholar 

  21. C. Marini, F. De Santis, S. Sacco, T. Russo, L. Olivieri, R. Totaro, A. Carolei, Contribution of atrial fibrillation to incidence and outcome of ischemic stroke: results from a population-based study. Stroke 36, 1115–1119 (2005)

    Article  Google Scholar 

  22. G.Y. Lip, R. Nieuwlaat, R. Pisters, D.A. Lane, H.J. Crijns, Refining clinical risk stratification for predicting stroke and thromboembolism in atrial fibrillation using a novel risk factor-based approach. The Euro Heart Survey on atrial fibrillation. Chest 137, 263–272 (2010)

    Article  Google Scholar 

  23. D.A. Lane, G.Y.H. Lip, Use of the CHA\(_2\)DS\(_2\)-VASc and HAS-BLED scores to aid decision making for thromboprophylaxis in nonvalvular atrial fibrillation. Circulation 126, 860–865 (2012)

    Article  Google Scholar 

  24. I. Savelieva, A.J. Camm, Clinical relevance of silent atrial fibrillation: prevalence, prognosis, quality of life, and management. J. Interv. Card. Electrophysiol. 4, 369–382 (2000)

    Article  Google Scholar 

  25. G.Y. Lip, C. Laroche, P.M. Ioachim, L.H. Rasmussen, L. Vitali-Serdoz, L. Petrescu, D. Darabantiu, H.J. Crijns, P. Kirchhof, P. Vardas, L. Tavazzi, A.P. Maggioni, G. Boriani, Prognosis and treatment of atrial fibrillation patients by European cardiologists: one year follow-up of the EURObservational Research Programme-Atrial Fibrillation General Registry Pilot Phase (EORP-AF Pilot registry). Eur. Heart J. 35, 3365–3376 (2014)

    Article  Google Scholar 

  26. J.S. Healey, S.J. Connolly, M.R. Gold, C.W. Israel, I.C. Van Gelder, A. Capucci, C.P. Lau, E. Fain, S. Yang, C. Bailleul, C.A. Morillo, M. Carlson, E. Themeles, E.S. Kaufman, S.H. Hohnloser, ASSERT Investigators, Subclinical atrial fibrillation and the risk of stroke. N. Engl. J. Med. 366, 120–129 (2012)

    Article  Google Scholar 

  27. D. Bengtsson, L. Brudin, P. Wanby, M. Carlsson, Previously unknown thyroid dysfunction in patients with acute ischemic stroke. Acta Neurol. Scand. 126, 98–102 (2012)

    Article  Google Scholar 

  28. L. Suissa, S. Lachaud, M.H. Mahagne, Optimal timing and duration of continuous electrocardiographic monitoring for detecting atrial fibrillation in stroke patients. J. Stroke Cerebrovasc. Dis. 22, 991–995 (2013)

    Article  Google Scholar 

  29. H. Kamel, K.R. Lees, P.D. Lyden, P.A. Teal, A. Shuaib, M. Ali, S.C. Johnston, Virtual International Stroke Trials Archive Investigators, Delayed detection of atrial fibrillation after ischemic stroke. J. Stroke Cerebrovasc. Dis. 18, 453–457 (2009)

    Article  Google Scholar 

  30. D. Jabaudon, J. Sztajzel, K. Sievert, T. Landis, R. Sztajzel, Usefulness of ambulatory 7-day ECG monitoring for the detection of atrial fibrillation and flutter after acute stroke and transient ischemic attack. Stroke 35, 1647–1651 (2004)

    Article  Google Scholar 

  31. R. Stahrenberg, M. Weber-Krüger, J. Seegers, F. Edelmann, R. Lahno, B. Haase, M. Mende, J. Wohlfahrt, P. Kermer, D. Vollmann, G. Hasenfuss, K. Gröschel, R. Wachter, Enhanced detection of paroxysmal atrial fibrillation by early and prolonged continuous holter monitoring in patients with cerebral ischemia presenting in sinus rhythm. Stroke 41, 2884–2888 (2010)

    Article  Google Scholar 

  32. A.C. Flint, N.M. Banki, X. Ren, V.A. Rao, A.S. Go, Detection of paroxysmal atrial fibrillation by 30-day event monitoring in cryptogenic ischemic stroke: the stroke and monitoring for PAF in real time (SMART) registry. Stroke 43, 2788–2790 (2012)

    Article  Google Scholar 

  33. D.J. Miller, M.A. Khan, R. Schultz, J.R. Simpson, A.M. Katramados, A.N. Russman, Outpatient cardiac telemetry detects a high rate of atrial fibrillation in cryptogenic stroke. J. Neurol. Sci. 324, 57–61 (2013)

    Article  Google Scholar 

  34. L. Elijovich, S.A. Josephson, G.L. Fung, W.S. Smith, Intermittent atrial fibrillation may account for a large proportion of otherwise cryptogenic stroke: a study of 30-day cardiac event monitors. J. Stroke Cerebrovasc. Dis. 18, 185–189 (2009)

    Article  Google Scholar 

  35. J. Brachmann, C.A. Morillo, T. Sanna, V. Di Lazzaro, H.C. Diener, R.A. Bernstein, M. Rymer, P.D. Ziegler, S. Liu, R.S. Passman, Uncovering atrial fibrillation beyond short-term monitoring in cryptogenic stroke patients: three-year results from the cryptogenic stroke and underlying atrial fibrillation trial. Circ. Arrhythm. Electrophysiol. 9, e003333 (2016)

    Article  Google Scholar 

  36. J. Reiffel, A. Verma, J.L. Halperin, B. Gersh, S. Tombul, J. Carrithers, L. Sherfesee, P. Kowey, Rationale and design of REVEAL AF: a prospective study of previously undiagnosed atrial fibrillation as documented by an insertable cardiac monitor in high-risk patients. Am. Heart J. 167, 22–27 (2014)

    Article  Google Scholar 

  37. D.J. Gladstone, M. Spring, P. Dorian, V. Panzov, K.E. Thorpe, J. Hall, H. Vaid, M. O’Donnell, A. Laupacis, R. Côté, M. Sharma, J.A. Blakely, A. Shuaib, V. Hachinski, S.B. Coutts, D.J. Sahlas, P. Teal, S. Yip, J.D. Spence, B. Buck, S. Verreault, L.K. Casaubon, A. Penn, D. Selchen, A. Jin, D. Howse, M. Mehdiratta, K. Boyle, R. Aviv, M.K. Kapral, M. Mamdani, Atrial fibrillation in patients with cryptogenic stroke. N. Engl. J. Med. 370, 2467–2477 (2014)

    Article  Google Scholar 

  38. T. Sanna, H.-C. Diener, R.S. Passman, V. Di Lazzaro, R.A. Bernstein, C.A. Morillo, M.M. Rymer, V. Thijs, T. Rogers, F. Beckers, K. Lindborg, J. Brachmann, Cryptogenic stroke and underlying atrial fibrillation. N. Engl. J. Med. 370, 2478–2486 (2014)

    Article  Google Scholar 

  39. J. Benezet-Mazuecos, J.M. Rubio, J. Farré, Atrial high rate episodes in patients with dual-chamber cardiac implantable electronic devices: unmasking silent atrial fibrillation. Pacing Clin. Electrophysiol. 37, 1080–1086 (2014)

    Article  Google Scholar 

  40. T.V. Glotzer, A.S. Hellkamp, J. Zimmerman, M.O. Sweeney, R. Yee, R. Marinchak, J. Cook, A. Paraschos, J. Love, G. Radoslovich, K.L. Lee, G.A. Lamas, M.O.S.T. Investigators, Atrial high rate episodes detected by pacemaker diagnostics predict death and stroke: report of the Atrial Diagnostics Ancillary Study of the MOde Selection Trial (MOST). Circulation 107, 1614–1619 (2003)

    Article  Google Scholar 

  41. T.V. Glotzer, E.G. Daoud, D.G. Wyse, D.E. Singer, M.D. Ezekowitz, C. Hilker, C. Miller, D. Qi, P.D. Ziegler, The relationship between daily atrial tachyarrhythmia burden from implantable device diagnostics and stroke risk: the TRENDS study. Circulation. Arrhythm. Electrophysiol. 2, 474–480 (2009)

    Article  Google Scholar 

  42. S.H. Hohnloser, A. Capucci, E. Fain, M.R. Gold, I.C. van Gelder, J. Healey, C.W. Israel, C.P. Lau, C. Morillo, S.J. Connolly, A.S.S.E.R.T. Investigators, Committees, ASymptomatic atrial fibrillation and Stroke Evaluation in pacemaker patients and the atrial fibrillation Reduction atrial pacing Trial (ASSERT). Am. Heart J. 152, 442–447 (2006)

    Google Scholar 

  43. D.T. Martin, M.M. Bersohn, A.L. Waldo, M.S. Wathen, W.K. Choucair, G.Y.H. Lip, J. Ip, R. Holcomb, J.G. Akar, J.L. Halperin, IMPACT Investigators, Randomized trial of atrial arrhythmia monitoring to guide anticoagulation in patients with implanted defibrillator and cardiac resynchronization devices. Eur. Heart J. 36, 1660–1668 (2015)

    Article  Google Scholar 

  44. B.J. Hirsh, R.S. Copeland-Halperin, J.L. Halperin, Fibrotic atrial cardiomyopathy, atrial fibrillation, and thromboembolism: mechanistic links and clinical inferences. J. Am. Coll. Cardiol. 65, 2239–2251 (2015)

    Article  Google Scholar 

  45. K.M. Henriksson, B. Farahmand, S. Asberg, A. Terént, N. Edvardsson, First-ever atrial fibrillation documented after hemorrhagic or ischemic stroke: the role of the CHADS\(_2\) score at the time of stroke. Clin. Cardiol. 34, 309–316 (2011)

    Article  Google Scholar 

  46. M.A. Baturova, A. Lindgren, J. Carlson, Y.V. Shubik, S.B. Olsson, P.G. Platonov, Predictors of new onset atrial fibrillation during 10-year follow-up after first-ever ischemic stroke. Int. J. Cardiol. 199, 248–252 (2015)

    Article  Google Scholar 

  47. M.-L. Zuo, S. Liu, K.-H. Chan, K.-K. Lau, B.-H. Chong, K.-F. Lam, Y.-H. Chan, Y.-F. Lau, G.Y.H. Lip, C.-P. Lau, H.-F. Tse, C.-W. Siu, The CHADS\(_2\) and CHA\(_2\)DS\(_2\)-VASc scores predict new occurrence of atrial fibrillation and ischemic stroke. J. Interv. Card. Electrophysiol. 37, 47–54 (2013)

    Article  Google Scholar 

  48. S. Suzuki, K. Sagara, T. Otsuka, H. Kano, S. Matsuno, H. Takai, T. Uejima, Y. Oikawa, A. Koike, K. Nagashima, H. Kirigaya, J. Yajima, H. Tanabe, H. Sawada, T. Aizawa, T. Yamashita, Usefulness of frequent supraventricular extrasystoles and a high CHADS\(_2\) score to predict first-time appearance of atrial fibrillation. Am. J. Cardiol. 111, 1602–1607 (2013)

    Article  Google Scholar 

  49. I.C. Van Gelder, H.F. Groenveld, H.J.G.M. Crijns, Y.S. Tuininga, J.G.P. Tijssen, A.M. Alings, H.L. Hillege, J.A. Bergsma-Kadijk, J.H. Cornel, O. Kamp, R. Tukkie, H.A. Bosker, D.J. Van Veldhuisen, M.P. Van den Berg, R.A.C.E.I.I. Investigators, Lenient versus strict rate control in patients with atrial fibrillation. N. Engl. J. Med. 362, 1363–1373 (2010)

    Article  Google Scholar 

  50. M. Haïssaguerre, P. Jaïs, D.C. Shah, A. Takahashi, M. Hocini, G. Quiniou, S. Garrigue, A. Le Mouroux, P. Le Métayer, J. Clémenty, Spontaneous initiation of atrial fibrillation by ectopic beats originating in the pulmonary veins. N. Engl. J. Med. 339, 659–666 (1998)

    Article  Google Scholar 

  51. J.C. Nielsen, A. Johannessen, P. Raatikainen, G. Hindricks, H. Walfridsson, S.M. Pehrson, A. Englund, J. Hartikainen, L.S. Mortensen, P.S. Hansen, MANTRA-PAF Investigators, Long-term efficacy of catheter ablation as first-line therapy for paroxysmal atrial fibrillation: 5-year outcome in a randomised clinical trial. Heart 103, 368–376 (2017)

    Article  Google Scholar 

  52. P.G. Platonov, V.D.A. Corino, M. Seifert, F. Holmqvist, L. Sörnmo, Atrial fibrillatory rate in the clinical context: natural course and prediction of intervention outcome. Europace 16, iv110–iv119 (2014)

    Article  Google Scholar 

  53. T. Lankveld, C.B. de Vos, I. Limantoro, S. Zeemering, E. Dudink, H.J. Crijns, U. Schotten, Systematic analysis of ECG predictors of sinus rhythm maintenance after electrical cardioversion for persistent atrial fibrillation. Heart Rhythm 13, 1020–1027 (2016)

    Article  Google Scholar 

  54. D.D. McManus, J. Lee, O. Maitas, N. Esa, R. Pidikiti, A. Carlucci, J. Harrington, E. Mick, K.H. Chon, A novel application for the detection of an irregular pulse using an iPhone 4S in patients with atrial fibrillation. Heart Rhythm 10, 315–319 (2013)

    Article  Google Scholar 

  55. A.-S. Olsson, J. Engdahl, Detection of atrial fibrillation with intermittent handheld electrocardiogram in patients with ischemic stroke and transient ischemic attack and transient ischemic attack. J. Stroke Cerebrovasc. Dis. 25, 2648–2652 (2016)

    Article  Google Scholar 

  56. J.K. Lau, N. Lowres, L. Neubeck, D.B. Brieger, R.W. Sy, C.D. Galloway, D.E. Albert, S.B. Freedman, iPhone ECG application for community screening to detect silent atrial fibrillation: a novel technology to prevent stroke. Int. J. Cardiol. 165, 193–194 (2013)

    Article  Google Scholar 

  57. J.P.J. Halcox, K. Wareham, A. Cardew, M. Gilmore, J.P. Barry, C. Phillips, M.B. Gravenor, Assessment of remote heart rhythm sampling using the Alivecor heart monitor to screen for atrial fibrillation: the REHEARSE-AF study. Circulation 136, 1784–1794 (2017)

    Article  Google Scholar 

  58. G.C. Flaker, K. Belew, K. Beckman, H. Vidaillet, J. Kron, R. Safford, M. Mickel, P. Barrell, AFFIRM Investigators, Asymptomatic atrial fibrillation: demographic features and prognostic information from the Atrial Fibrillation Follow-up Investigation of Rhythm Management (AFFIRM) study. Am. Heart J. 149, 657–663 (2005)

    Article  Google Scholar 

  59. European Society of Cardiology, (ESC), European Heart Rhythm Association (EHRA), M. Brignole, A. Auricchio, G. Baron-Esquivias, P. Bordachar, G. Boriani, O.-A. Breithardt, J. Cleland, J.-C. Deharo, V. Delgado, P.M. Elliott, B. Gorenek, C.W. Israel, C. Leclercq, C. Linde, L. Mont, L. Padeletti, R. Sutton, P.E. Vardas, 2013 ESC guidelines on cardiac pacing and cardiac resynchronization therapy: the task force on cardiac pacing and resynchronization therapy of the European Society of Cardiology (ESC). Developed in collaboration with the European Heart Rhythm Association. Europace 15, 1070–1118 (2013)

    Google Scholar 

  60. A. Bollmann, A. Tveit, D. Husser, M. Stridh, L. Sörnmo, P. Smith, S.B. Olsson, Fibrillatory rate response to candesartan in persistent atrial fibrillation. Europace 10, 1138–1144 (2008)

    Article  Google Scholar 

  61. F. Holmqvist, M. Stridh, J.E. Waktare, L. Sörnmo, S.B. Olsson, C.J. Meurling, Atrial fibrillatory rate and sinus rhythm maintenance in patients undergoing cardioversion of persistent atrial fibrillation. Eur. Heart J. 27, 2201–2207 (2006)

    Article  Google Scholar 

  62. M.B. Choudhary, F. Holmqvist, J. Carlson, H.-J. Nilsson, A. Roijer, P.G. Platonov, Low atrial fibrillatory rate is associated with spontaneous conversion of recent-onset atrial fibrillation. Europace 15, 1445–1452 (2013)

    Article  Google Scholar 

  63. C.J. Meurling, J.E. Waktare, F. Holmqvist, A. Hedman, A.J. Camm, S.B. Olsson, M. Malik, Diurnal variations of the dominant cycle length of chronic atrial fibrillation. Am. J. Physiol. 280, H401–H406 (2001)

    Google Scholar 

  64. F. Sandberg, A. Bollmann, D. Husser, M. Stridh, L. Sörnmo, Circadian variation in dominant atrial fibrillation frequency in persistent atrial fibrillation. Physiol. Meas. 31, 531–542 (2010)

    Article  Google Scholar 

  65. S. Petrutiu, A.V. Sahakian, S. Swiryn, Short-term dynamics in fibrillatory wave characteristics at the onset of paroxysmal atrial fibrillation in humans. J. Electrocardiol. 40, 155–160 (2007)

    Article  Google Scholar 

  66. P.G. Platonov, M. Stridh, M. de Melis, L. Urban, J. Carlson, G. Corbucci, F. Holmqvist, Analysis of atrial fibrillatory rate during spontaneous episodes of atrial fibrillation in humans using implantable loop recorder electrocardiogram. J. Electrocardiol. 45, 723–726 (2012)

    Article  Google Scholar 

  67. European Medicines Agency, Biomarkers (2017), http://www.ema.europa.eu/ema/. Accessed 17 Oct 2017

  68. Food and Drug Administration (FDA), Biomarker qualification program (2017), http://www.fda.gov/. Accessed 17 Oct 2017

  69. A.L. Goldberger, L.A. Amaral, L. Glass, J.M. Hausdorff, P.C. Ivanov, R.G. Mark, J.E. Mietus, G.B. Moody, C.K. Peng, H.E. Stanley, PhysioBank, PhysioToolkit, and PhysioNet: components of a new research resource for complex physiologic signals. Circulation 101, E215–220 (2000)

    Article  Google Scholar 

  70. J.-P. Couderc, The Telemetric and Holter ECG Warehouse Initiative (THEW): a data repository for the design, implementation and validation of ECG-related technologies, in Proceedings of IEEE Conference on Engineering in Medicine and Biology (EMBS) 32, 6252–6255 (2010)

    Google Scholar 

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Platonov, P.G., Corino, V.D.A. (2018). A Clinical Perspective on Atrial Fibrillation . In: Sörnmo, L. (eds) Atrial Fibrillation from an Engineering Perspective. Series in BioEngineering. Springer, Cham. https://doi.org/10.1007/978-3-319-68515-1_1

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