{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T21:28:22Z","timestamp":1792358902148,"version":"4.4.0"},"reference-count":23,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2023,10,23]],"date-time":"2023-10-23T00:00:00Z","timestamp":1698019200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004528","name":"Maastricht Universitair Medisch Centrum","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004528","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Cardiology"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>In the Rate Control versus Electrical Cardioversion Trial 7\u2013Acute Cardioversion versus Wait and See, patients with recent\u2010onset atrial fibrillation (AF) were randomized to either early or delayed cardioversion.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>This prespecified sub\u2010analysis aimed to evaluate heart rate during AF recurrences after an emergency department (ED) visit identified by an electrocardiogram (ECG)\u2010based handheld device.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>After the ED visit, included patients (<jats:italic>n<\/jats:italic>\u2009=\u2009437) were asked to use an ECG\u2010based handheld device to monitor for recurrences during the 4\u2010week follow\u2010up period. 335 patients used the handheld device and were included in this analysis. Recordings from the device were collected and assessed for heart rhythm and rate. Optimal rate control was defined as a target resting heart rate of &lt;110 beats per minute (bpm).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In 99 patients (29.6%, mean age 67\u2009\u00b1\u200910 years, 39.4% female, median 6 [3\u201312] AF recordings) a total of 314 AF recurrences (median 2 [1\u20133] per patient) were identified during follow\u2010up. The average median resting heart rate at recurrence was 100\u2009\u00b1\u200921 bpm in the delayed vs 112\u2009\u00b1\u200925 bpm in the early cardioversion group (<jats:italic>p<\/jats:italic>\u2009=\u2009.011). Optimal rate control was seen in 68.4% [21.3%\u2013100%] and 33.3% [0%\u201377.5%] of recordings (<jats:italic>p<\/jats:italic>\u2009=\u2009.01), respectively. Randomization group [coefficient \u221212.09 (\u221220.55 to \u22123.63, <jats:italic>p<\/jats:italic>\u2009=\u2009.006) for delayed vs. early cardioversion] and heart rate on index ECG [coefficient 0.46 (0.29\u20130.63, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001) per bpm increase] were identified on multivariable analysis as factors associated with lower median heart rate during AF recurrences.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>A delayed cardioversion strategy translated into a favorable heart rate profile during AF recurrences.<\/jats:p><\/jats:sec>","DOI":"10.1002\/clc.24161","type":"journal-article","created":{"date-parts":[[2023,10,24]],"date-time":"2023-10-24T06:25:24Z","timestamp":1698128724000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Cardioversion strategy impacts rate control during recurrences in patients with paroxysmal atrial fibrillation: A subanalysis of the RACE 7 ACWAS trial"],"prefix":"10.1002","volume":"47","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7144-3333","authenticated-orcid":false,"given":"Rachel M. J.","family":"van der Velden","sequence":"first","affiliation":[{"name":"Department of Cardiology Maastricht University Medical Centre and Cardiovascular Research Institute Maastricht Maastricht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9663-6315","authenticated-orcid":false,"given":"Nikki A. H. A.","family":"Pluymaekers","sequence":"additional","affiliation":[{"name":"Department of Cardiology Maastricht University Medical Centre and Cardiovascular Research Institute Maastricht Maastricht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4572-3969","authenticated-orcid":false,"given":"Elton A. M. P.","family":"Dudink","sequence":"additional","affiliation":[{"name":"Department of Cardiology Maastricht University Medical Centre and Cardiovascular Research Institute Maastricht Maastricht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justin G. L. M.","family":"Luermans","sequence":"additional","affiliation":[{"name":"Department of Cardiology Maastricht University Medical Centre and Cardiovascular Research Institute Maastricht Maastricht The Netherlands"},{"name":"Department of Cardiology RadboudUMC Nijmegen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joan G.","family":"Meeder","sequence":"additional","affiliation":[{"name":"Department of Cardiology VieCuri Medical Center Noord\u2010Limburg Venlo The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wilfred F.","family":"Heesen","sequence":"additional","affiliation":[{"name":"Department of Cardiology VieCuri Medical Center Noord\u2010Limburg Venlo The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timo","family":"Lenderink","sequence":"additional","affiliation":[{"name":"Department of Cardiology Zuyderland Medical Center Heerlen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos W. M. G.","family":"Widdershoven","sequence":"additional","affiliation":[{"name":"Department of Cardiology Elisabeth\u2010TweeSteden Hospital Tilburg The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeroen J. J.","family":"Bucx","sequence":"additional","affiliation":[{"name":"Department of Cardiology Diakonessenhuis Utrecht Utrecht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michiel","family":"Rienstra","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University of Groningen University Medical Center Groningen Groningen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Otto","family":"Kamp","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam UMC Vrije Universiteit Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jurren M.","family":"van Opstal","sequence":"additional","affiliation":[{"name":"Department of Cardiology Medical Spectrum Twente Enschede The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles J. H. J.","family":"Kirchhof","sequence":"additional","affiliation":[{"name":"Department of Cardiology Alrijne Hospital Leiderdorp The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincent F.","family":"van Dijk","sequence":"additional","affiliation":[{"name":"Department of Cardiology St. Antonius Hospital Nieuwegein The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henk P.","family":"Swart","sequence":"additional","affiliation":[{"name":"Department of Cardiology Antonius Hospital Sneek The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Alings","sequence":"additional","affiliation":[{"name":"Department of Cardiology Amphia Hospital Breda The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabelle C.","family":"Van Gelder","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University of Groningen University Medical Center Groningen Groningen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1073-5337","authenticated-orcid":false,"given":"Harry J. 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