{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T05:08:23Z","timestamp":1791263303541,"version":"4.1.0"},"reference-count":25,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"23","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[1999,6,15]]},"abstract":"<jats:p>\n                    <jats:italic>Background<\/jats:italic>\n                    \u2014The clinical presentation and causes of atrial fibrillation (AF) in the 1990s may differ from AF seen 2 to 3 decades ago. It was the objective of this prospective study to characterize various clinical presentations and underlying conditions of patients with AF observed in general practice in France.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:italic>Methods and Results<\/jats:italic>\n                    \u2014The study population comprised 756 patients (19 to 95 years of age) with electrocardiographically documented AF subdivided into paroxysmal (&lt;7 days), chronic (last episode &gt;1 month) and recent onset AF(persistent &gt;7 days and&lt;1 month). Symptoms were present in 670 patients (88.6%). The relative prevalences of paroxysmal, chronic, and recent onset AF were 22.1%, 51.4%, and 26.4%, respectively. Cardiac disorders, present in 534 patients (70.6%), included hypertension (39.4%), coronary artery disease (16.6%), and myocardial diseases (15.3%) as the most common. Rheumatic valvular disease represented a common cause in women (25.0%) but not in men (8.0%). The paroxysmal group differed by a high percentage of palpitations (79.0%) and a low percentage of underlying heart disease (53.9%). With a mean follow-up of 8.6\u00b13.7 months, 28 patients (3.7%) died, including 6 fatal cerebrovascular accidents. Among the 728 patients who survived, congestive heart failure occurred in 30 patients (4.1%), and embolic complications occurred in 13 patients (1.8%). In the paroxysmal AF group, 13 patients (8.0%) developed chronic AF and 51 (31.3%) had AF recurrences. At the time of follow-up, 53 patients (14.3%) from the chronic AF group and 108 patients (55.7%) from the recent onset AF group were in sinus rhythm.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:italic>Conclusions<\/jats:italic>\n                    \u2014This large-scale study establishes the current demographic profile of out-of-hospital patients with AF and highlights some of the changes that have occurred in the past decades, including a particular shift in cardiac causes toward nonrheumatic AF. This study also demonstrates significant differences between various subsets of AF.\n                  <\/jats:p>","DOI":"10.1161\/01.cir.99.23.3028","type":"journal-article","created":{"date-parts":[[2012,6,11]],"date-time":"2012-06-11T20:42:29Z","timestamp":1339447349000},"page":"3028-3035","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":430,"title":["Characterization of Different Subsets of Atrial Fibrillation in General Practice in France"],"prefix":"10.1161","volume":"99","author":[{"given":"Samuel","family":"Le\u0301vy","sequence":"first","affiliation":[{"name":"From the Division of Cardiology, University of Marseille, School of Medicine, France."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martine","family":"Maarek","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology, University of Marseille, School of Medicine, France."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philippe","family":"Coumel","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology, University of Marseille, School of Medicine, France."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Louis","family":"Guize","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology, University of Marseille, School of Medicine, France."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean","family":"Lekieffre","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology, University of Marseille, School of Medicine, France."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Louis","family":"Medvedowsky","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology, University of Marseille, School of Medicine, France."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alain","family":"Sebaoun","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology, University of Marseille, School of Medicine, France."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_1_2","first-page":"714","volume":"61","year":"1990","unstructured":"Cabin HS, Clubb KS, Hall C, Perlmutter RA, Feinstein AR. Risk for systemic embolization of atrial fibrillation without mitral stenosis. Am J Cardiol. 1990;61:714\u2013717.","journal-title":"Am J Cardiol"},{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.1987.00370090041008"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/str.22.8.1866765"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/str.17.4.3738942"},{"key":"e_1_3_2_5_2","unstructured":"Bialy D Lehmann MH Schumacher DN Steinman RT Meissmer MD. Hospitalization for arrhythmias in the United States: importance of atrial fibrillation. J Am Coll Cardiol. 1992;19(suppl3):41A. Abstract."},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1161\/str.17.4.3738942"},{"key":"e_1_3_2_7_2","doi-asserted-by":"crossref","unstructured":"Kerr C Boone J Connolly S Greene M Klein G Sheldon R Talajic M. Follow-up of atrial fibrillation: the initial experience of the Canadian Registry of Atrial Fibrillation. Eur Heart J. 1996;17(suppl C):48\u201351.","DOI":"10.1093\/eurheartj\/17.suppl_C.48"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.30.1.91"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.29.6.926"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9343(64)90021-X"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.eurheartj.a061163"},{"key":"e_1_3_2_12_2","unstructured":"Godtfresen J. Atrial fibrillation: course and prognosis. A follow-up study of 1212 cases. In: Kulbertus HE Olsson SB Schlepper M eds. Atrial Fibrillation. M\u00f6lndal Sweden: AB H\u00e4ssle; 1982:134\u2013145."},{"key":"e_1_3_2_13_2","unstructured":"Kulbertus HE Leval-Rutten F Bartsh P Petit JM. Atrial fibrillation in elderly ambulatory patients. In: Kulbertus HE Olsson SB Schlepper M eds. Atrial Fibrillation. M\u00f6lndal Sweden: AB H\u00e4ssle; 1982:148\u2013154."},{"key":"e_1_3_2_14_2","first-page":"597","volume":"35","year":"1986","unstructured":"Delahaye JP, Milon H, Boissonat P. La fibrillation auriculaire: quelques probl\u00e9mes pratiques actuels. Ann Cardiol Angeiol. 1986;35:597\u2013606.","journal-title":"Ann Cardiol Angeiol"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.1989.00390020145033"},{"key":"e_1_3_2_16_2","unstructured":"Bellet S. Atrial fibrillation (clinical manifestations) In: Clinical Disorders of the Heartbeat. Philadelphia Pa: Lea and Febiger; 1971:223\u2013233."},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.55.4.613"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(96)09145-3"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.2307\/2347973"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1080\/01621459.1952.10483441"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198709103171104"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1985.03360240061035"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.16.2.189"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-8703(83)90208-9"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1161\/circ.89.1.8281651"}],"container-title":["Circulation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/01.CIR.99.23.3028","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,12]],"date-time":"2024-05-12T12:50:40Z","timestamp":1715518240000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/01.CIR.99.23.3028"}},"subtitle":["The ALFA Study"],"short-title":[],"issued":{"date-parts":[[1999,6,15]]},"references-count":25,"journal-issue":{"issue":"23","published-print":{"date-parts":[[1999,6,15]]}},"alternative-id":["10.1161\/01.CIR.99.23.3028"],"URL":"https:\/\/doi.org\/10.1161\/01.cir.99.23.3028","relation":{},"ISSN":["0009-7322","1524-4539"],"issn-type":[{"value":"0009-7322","type":"print"},{"value":"1524-4539","type":"electronic"}],"subject":[],"published":{"date-parts":[[1999,6,15]]},"assertion":[{"value":"1998-07-30","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"1999-03-26","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"1999-06-15","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}