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Permanent atrial fibrillation

MedGen UID:
750308
Concept ID:
C2586056
Pathologic Function
Synonym: Chronic atrial fibrillation
SNOMED CT: Permanent atrial fibrillation (440028005)
 
HPO: HP:0004754

Definition

Atrial fibrillation (AF) that cannot be successfully terminated by cardioversion, and longstanding (more than 1 year) AF, where cardioversion is not indicated or has not been attempted, is termed permanent. [from HPO]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVPermanent atrial fibrillation

Conditions with this feature

Atrial fibrillation, familial, 3
MedGen UID:
373232
Concept ID:
C1837014
Disease or Syndrome
Atrial fibrillation (AF) is the most common sustained cardiac rhythm disturbance, affecting more than 2 million Americans, with an overall prevalence of 0.89%. The prevalence increases rapidly with age, to 2.3% between the ages of 40 and 60 years, and to 5.9% over the age of 65. The most dreaded complication is thromboembolic stroke (Brugada et al., 1997). For a discussion of genetic heterogeneity of atrial fibrillation, see 608583.
Lown-Ganong-Levine syndrome
MedGen UID:
354734
Concept ID:
C1862387
Disease or Syndrome
Lown-Ganong-Levine syndrome is an extremely rare conduction disorder characterized by a short PR interval (less than or equal to 120 ms) with normal QRS complex on electrocardiogram associated with the occurrence of episodes of atrial tachyarrythmias (e.g. atrial fibrillation, atrial tachycardia).
Atrial fibrillation, familial, 4
MedGen UID:
400041
Concept ID:
C1862394
Disease or Syndrome
Atrial fibrillation is the most common sustained cardiac rhythm disturbance, affecting more than 2 million Americans, with an overall prevalence of 0.89%. The prevalence increases rapidly with age, to 2.3% between the ages of 40 and 60 years, and to 5.9% over the age of 65. The most dreaded complication is thromboembolic stroke (Brugada et al., 1997). For a discussion of genetic heterogeneity of atrial fibrillation, see 608583.
Atrial fibrillation, familial, 7
MedGen UID:
393658
Concept ID:
C2677106
Disease or Syndrome
Atrial fibrillation (AF) is the most common sustained cardiac rhythm disturbance, affecting more than 2 million Americans, with an overall prevalence of 0.89%. The prevalence increases rapidly with age, to 2.3% between the ages of 40 and 60 years, and to 5.9% over the age of 65. The most dreaded complication is thromboembolic stroke (Brugada et al., 1997). For a discussion of genetic heterogeneity of atrial fibrillation, see 608583.
Brugada syndrome 7
MedGen UID:
413472
Concept ID:
C2751088
Disease or Syndrome
Brugada syndrome is characterized by cardiac conduction abnormalities (ST segment abnormalities in leads V1-V3 on EKG and a high risk for ventricular arrhythmias) that can result in sudden death. Brugada syndrome presents primarily during adulthood, although age at diagnosis may range from infancy to late adulthood. The mean age of sudden death is approximately 40 years. Clinical presentations may also include sudden infant death syndrome (SIDS; death of a child during the first year of life without an identifiable cause) and sudden unexpected nocturnal death syndrome (SUNDS), a typical presentation in individuals from Southeast Asia. Other conduction defects can include first-degree AV block, intraventricular conduction delay, right bundle branch block, and sick sinus syndrome.
Long QT syndrome 13
MedGen UID:
462083
Concept ID:
C3150733
Disease or Syndrome
Long QT syndrome (LQTS) is a cardiac electrophysiologic disorder, characterized by QT prolongation and T-wave abnormalities on the EKG that are associated with tachyarrhythmias, typically the ventricular tachycardia torsade de pointes (TdP). TdP is usually self-terminating, thus causing a syncopal event, the most common symptom in individuals with LQTS. Such cardiac events typically occur during exercise and emotional stress, less frequently during sleep, and usually without warning. In some instances, TdP degenerates to ventricular fibrillation and causes aborted cardiac arrest (if the individual is defibrillated) or sudden death. Approximately 50% of untreated individuals with a pathogenic variant in one of the genes associated with LQTS have symptoms, usually one to a few syncopal events. While cardiac events may occur from infancy through middle age, they are most common from the preteen years through the 20s. Some types of LQTS are associated with a phenotype extending beyond cardiac arrhythmia. In addition to the prolonged QT interval, associations include muscle weakness and facial dysmorphism in Andersen-Tawil syndrome (LQTS type 7); hand/foot, facial, and neurodevelopmental features in Timothy syndrome (LQTS type 8); and profound sensorineural hearing loss in Jervell and Lange-Nielson syndrome.
Atrial fibrillation, familial, 9
MedGen UID:
462781
Concept ID:
C3151431
Disease or Syndrome
Atrial fibrillation is the most common sustained cardiac rhythm disturbance, affecting more than 2 million Americans, with an overall prevalence of 0.89%. The prevalence increases rapidly with age, to 2.3% between the ages of 40 and 60 years, and to 5.9% over the age of 65. The most dreaded complication is thromboembolic stroke (Brugada et al., 1997). For a discussion of genetic heterogeneity of atrial fibrillation, see 608583.
Atrial fibrillation, familial, 10
MedGen UID:
462814
Concept ID:
C3151464
Disease or Syndrome
Atrial fibrillation is the most common sustained cardiac rhythm disturbance, affecting more than 2 million Americans, with an overall prevalence of 0.89%. The prevalence increases rapidly with age, to 2.3% between the ages of 40 and 60 years, and to 5.9% over the age of 65. The most dreaded complication is thromboembolic stroke (Brugada et al., 1997). For a discussion of genetic heterogeneity of atrial fibrillation, see 608583.
Atrial fibrillation, familial, 18
MedGen UID:
934603
Concept ID:
C4310636
Disease or Syndrome
Familial atrial fibrillation is an inherited abnormality of the heart's normal rhythm. Atrial fibrillation is characterized by episodes of uncoordinated electrical activity (fibrillation) in the heart's upper chambers (the atria), which cause a fast and irregular heartbeat. If untreated, this abnormal heart rhythm (arrhythmia) can lead to dizziness, chest pain, a sensation of fluttering or pounding in the chest (palpitations), shortness of breath, or fainting (syncope). Atrial fibrillation also increases the risk of stroke and sudden death. Complications of atrial fibrillation can occur at any age, although some people with this heart condition never experience any health problems associated with the disorder.
Hypertrophic cardiomyopathy 26
MedGen UID:
934716
Concept ID:
C4310749
Disease or Syndrome
Familial cardiomyopathy caused by mutation in the FLNC gene has been described as hypertrophic, restrictive, dilated, or arrhythmogenic right ventricular cardiomyopathy. Affected individuals, especially those with dilated cardiomyopathy, are at risk for arrhythmias and sudden death. Arrhythmias without cardiomyopathy, and left ventricular noncompaction, have also been reported (Ortiz-Genga et al., 2016; Verdonschot et al., 2020).

Professional guidelines

PubMed

Khan MH, Rochlani Y, Aronow WS
Expert Opin Drug Saf 2017 Dec;16(12):1407-1412. Epub 2017 Oct 6 doi: 10.1080/14740338.2017.1387246. PMID: 28960089
Shukla A, Curtis AB
Vasc Health Risk Manag 2014;10:1-12. Epub 2013 Dec 16 doi: 10.2147/VHRM.S49334. PMID: 24379678Free PMC Article
Maund E, McKenna C, Sarowar M, Fox D, Stevenson M, Pepper C, Palmer S, Woolacott N
Health Technol Assess 2010 Oct;14(Suppl. 2):55-62. doi: 10.3310/hta14suppl2/08. PMID: 21047492

Recent clinical studies

Etiology

Nesti L, Tricò D, Mengozzi A, Natali A
Cardiovasc Diabetol 2021 May 18;20(1):109. doi: 10.1186/s12933-021-01294-7. PMID: 34006325Free PMC Article
Kotecha D, Bunting KV, Gill SK, Mehta S, Stanbury M, Jones JC, Haynes S, Calvert MJ, Deeks JJ, Steeds RP, Strauss VY, Rahimi K, Camm AJ, Griffith M, Lip GYH, Townend JN, Kirchhof P; Rate Control Therapy Evaluation in Permanent Atrial Fibrillation (RATE-AF) Team
JAMA 2020 Dec 22;324(24):2497-2508. doi: 10.1001/jama.2020.23138. PMID: 33351042Free PMC Article
Reddy YNV, Obokata M, Verbrugge FH, Lin G, Borlaug BA
J Am Coll Cardiol 2020 Sep 1;76(9):1051-1064. doi: 10.1016/j.jacc.2020.07.009. PMID: 32854840Free PMC Article
Mischke K, Knackstedt C, Marx N, Vollmann D
Minerva Med 2013 Apr;104(2):119-30. PMID: 23514988
Medi C, Hankey GJ, Freedman SB
Med J Aust 2007 Feb 19;186(4):197-202. doi: 10.5694/j.1326-5377.2007.tb00862.x. PMID: 17309423

Diagnosis

Ciesielski A, Boczar K, Siekiera M, Gajek J, Sławuta A
Acta Cardiol 2022 Apr;77(2):114-121. Epub 2021 May 19 doi: 10.1080/00015385.2021.1901021. PMID: 34006173
Malavasi VL, Fantecchi E, Tordoni V, Melara L, Barbieri A, Vitolo M, Lip GYH, Boriani G
Intern Emerg Med 2021 Aug;16(5):1131-1140. Epub 2020 Nov 7 doi: 10.1007/s11739-020-02551-5. PMID: 33161524
Chaudhry MA, Johnson A, Heywood JT
Curr Hypertens Rev 2019;15(1):17-21. doi: 10.2174/1573402114666180917095654. PMID: 30221604
Dorian P, Angaran P
Can J Cardiol 2014 May;30(5 Suppl):S38-41. Epub 2013 Oct 9 doi: 10.1016/j.cjca.2013.09.029. PMID: 24530215
Shukla A, Curtis AB
Vasc Health Risk Manag 2014;10:1-12. Epub 2013 Dec 16 doi: 10.2147/VHRM.S49334. PMID: 24379678Free PMC Article

Therapy

Brignole M, Pentimalli F, Palmisano P, Landolina M, Quartieri F, Occhetta E, Calò L, Mascia G, Mont L, Vernooy K, van Dijk V, Allaart C, Fauchier L, Gasparini M, Parati G, Soranna D, Rienstra M, Van Gelder IC; APAF-CRT Trial Investigators
Eur Heart J 2021 Dec 7;42(46):4731-4739. doi: 10.1093/eurheartj/ehab569. PMID: 34453840
Nesti L, Tricò D, Mengozzi A, Natali A
Cardiovasc Diabetol 2021 May 18;20(1):109. doi: 10.1186/s12933-021-01294-7. PMID: 34006325Free PMC Article
Kotecha D, Bunting KV, Gill SK, Mehta S, Stanbury M, Jones JC, Haynes S, Calvert MJ, Deeks JJ, Steeds RP, Strauss VY, Rahimi K, Camm AJ, Griffith M, Lip GYH, Townend JN, Kirchhof P; Rate Control Therapy Evaluation in Permanent Atrial Fibrillation (RATE-AF) Team
JAMA 2020 Dec 22;324(24):2497-2508. doi: 10.1001/jama.2020.23138. PMID: 33351042Free PMC Article
Mischke K, Knackstedt C, Marx N, Vollmann D
Minerva Med 2013 Apr;104(2):119-30. PMID: 23514988
Medi C, Hankey GJ, Freedman SB
Med J Aust 2007 Feb 19;186(4):197-202. doi: 10.5694/j.1326-5377.2007.tb00862.x. PMID: 17309423

Prognosis

Reddy YNV, Obokata M, Verbrugge FH, Lin G, Borlaug BA
J Am Coll Cardiol 2020 Sep 1;76(9):1051-1064. doi: 10.1016/j.jacc.2020.07.009. PMID: 32854840Free PMC Article
Chaudhry MA, Johnson A, Heywood JT
Curr Hypertens Rev 2019;15(1):17-21. doi: 10.2174/1573402114666180917095654. PMID: 30221604
Dorian P, Angaran P
Can J Cardiol 2014 May;30(5 Suppl):S38-41. Epub 2013 Oct 9 doi: 10.1016/j.cjca.2013.09.029. PMID: 24530215
Shukla A, Curtis AB
Vasc Health Risk Manag 2014;10:1-12. Epub 2013 Dec 16 doi: 10.2147/VHRM.S49334. PMID: 24379678Free PMC Article
Van Gelder IC, Groenveld HF, Crijns HJ, Tuininga YS, Tijssen JG, Alings AM, Hillege HL, Bergsma-Kadijk JA, Cornel JH, Kamp O, Tukkie R, Bosker HA, Van Veldhuisen DJ, Van den Berg MP; RACE II Investigators
N Engl J Med 2010 Apr 15;362(15):1363-73. Epub 2010 Mar 15 doi: 10.1056/NEJMoa1001337. PMID: 20231232

Clinical prediction guides

Kotecha D, Bunting KV, Gill SK, Mehta S, Stanbury M, Jones JC, Haynes S, Calvert MJ, Deeks JJ, Steeds RP, Strauss VY, Rahimi K, Camm AJ, Griffith M, Lip GYH, Townend JN, Kirchhof P; Rate Control Therapy Evaluation in Permanent Atrial Fibrillation (RATE-AF) Team
JAMA 2020 Dec 22;324(24):2497-2508. doi: 10.1001/jama.2020.23138. PMID: 33351042Free PMC Article
Chutani SK, Shah AN, Kantharia BK
Curr Opin Cardiol 2017 Jan;32(1):22-26. doi: 10.1097/HCO.0000000000000355. PMID: 27875476
Platonov PG, Corino VD, Seifert M, Holmqvist F, Sörnmo L
Europace 2014 Nov;16 Suppl 4:iv110-iv119. doi: 10.1093/europace/euu249. PMID: 25362161
Mischke K, Knackstedt C, Marx N, Vollmann D
Minerva Med 2013 Apr;104(2):119-30. PMID: 23514988
Medi C, Hankey GJ, Freedman SB
Med J Aust 2007 Feb 19;186(4):197-202. doi: 10.5694/j.1326-5377.2007.tb00862.x. PMID: 17309423

Recent systematic reviews

Yin J, Hu H, Wang Y, Xue M, Li X, Cheng W, Li X, Yan S
Clin Cardiol 2014 Nov;37(11):707-15. Epub 2014 Aug 25 doi: 10.1002/clc.22312. PMID: 25156448Free PMC Article
Reed JL, Mark AE, Reid RD, Pipe AL
Can J Cardiol 2013 Dec;29(12):1721-8. doi: 10.1016/j.cjca.2013.09.020. PMID: 24267810
Maund E, McKenna C, Sarowar M, Fox D, Stevenson M, Pepper C, Palmer S, Woolacott N
Health Technol Assess 2010 Oct;14(Suppl. 2):55-62. doi: 10.3310/hta14suppl2/08. PMID: 21047492

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