{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T16:23:55Z","timestamp":1792686235815,"version":"4.5.0"},"reference-count":38,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Arrhythmia and Electrophysiology"],"published-print":{"date-parts":[[2020,3]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Atrial fibrillation (AF) may occur after an acute precipitant and subsequently resolve. Management guidelines for AF in these settings are unclear as the risk of recurrent AF and related morbidity is poorly understood. We examined the relations between acute precipitants of AF and long-term recurrence of AF in a clinical setting.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>From a multi-institutional longitudinal electronic medical record database, we identified patients with newly diagnosed AF between 2000 and 2014. We developed algorithms to identify acute AF precipitants (surgery, sepsis, pneumonia, pneumothorax, respiratory failure, myocardial infarction, thyrotoxicosis, alcohol, pericarditis, pulmonary embolism, and myocarditis). We assessed risks of AF recurrence in individuals with and without a precipitant and the relations between AF recurrence and heart failure, stroke, and mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Among 10 723 patients with newly diagnosed AF (67.9\u00b19.9 years, 41% women), 19% had an acute AF precipitant, the most common of which were cardiac surgery (22%), pneumonia (20%), and noncardiothoracic surgery (15%). The cumulative incidence of AF recurrence at 5 years was 41% among individuals with a precipitant compared with 52% in those without a precipitant (adjusted hazard ratio [HR], 0.75 [95% CI, 0.69\u20130.81];\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.001). The lowest risk of recurrence among those with precipitants occurred with postoperative AF (5-year incidence 32% in cardiac surgery and 39% in noncardiothoracic surgery). Regardless of the presence of an initial precipitant, recurrent AF was associated with increased adjusted risks of heart failure (hazard ratio, 2.74 [95% CI, 2.39\u20133.15];\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.001), stroke (hazard ratio, 1.57 [95% CI, 1.30\u20131.90];\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.001), and mortality (hazard ratio, 2.96 [95% CI, 2.70\u20133.24];\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>AF after an acute precipitant frequently recurs, although the risk of recurrence is lower than among individuals without an acute precipitant. Recurrence is associated with substantial long-term morbidity and mortality. Future studies should address surveillance and management after newly diagnosed AF in the setting of an acute precipitant.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/circep.119.007716","type":"journal-article","created":{"date-parts":[[2020,2,12]],"date-time":"2020-02-12T17:11:28Z","timestamp":1581527488000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":89,"title":["Initial Precipitants and Recurrence of Atrial Fibrillation"],"prefix":"10.1161","volume":"13","author":[{"given":"Elizabeth Y.","family":"Wang","sequence":"first","affiliation":[{"name":"Cardiovascular Research Center (E.Y.W., O.L.H., S.K., L.-C.W., P.T.E.), Cardiac Arrhythmia Service, Massachusetts General Hospital, Boston."},{"name":"Department of Medicine, Columbia University Medical Center, New York, NY (E.Y.W.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olivia L.","family":"Hulme","sequence":"additional","affiliation":[{"name":"Cardiovascular Research Center (E.Y.W., O.L.H., S.K., L.-C.W., P.T.E.), Cardiac Arrhythmia Service, Massachusetts General Hospital, Boston."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shaan","family":"Khurshid","sequence":"additional","affiliation":[{"name":"Cardiovascular Research Center (E.Y.W., O.L.H., S.K., L.-C.W., P.T.E.), Cardiac Arrhythmia Service, Massachusetts General Hospital, Boston."},{"name":"Division of Cardiology (S.K., S.A.L.), Cardiac Arrhythmia Service, Massachusetts General Hospital, Boston."},{"name":"Cardiovascular Disease Initiative, The Broad Institute of Harvard and MIT, Cambridge, MA (S.K., L.-C.W., S.H.C., P.T.E., S.A.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lu-Chen","family":"Weng","sequence":"additional","affiliation":[{"name":"Cardiovascular Research Center (E.Y.W., O.L.H., S.K., L.-C.W., P.T.E.), Cardiac Arrhythmia Service, Massachusetts General Hospital, Boston."},{"name":"Cardiovascular Disease Initiative, The Broad Institute of Harvard and MIT, Cambridge, MA (S.K., L.-C.W., S.H.C., P.T.E., S.A.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seung Hoan","family":"Choi","sequence":"additional","affiliation":[{"name":"Cardiovascular Disease Initiative, The Broad Institute of Harvard and MIT, Cambridge, MA (S.K., L.-C.W., S.H.C., P.T.E., S.A.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allan J.","family":"Walkey","sequence":"additional","affiliation":[{"name":"Boston University School of Medicine (A.J.W.), Harvard Medical School, MA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey M.","family":"Ashburner","sequence":"additional","affiliation":[{"name":"Division of General Internal Medicine (J.M.A., D.E.S., S.J.A.), Cardiac Arrhythmia Service, Massachusetts General Hospital, Boston."},{"name":"Department of Medicine (J.M.A., D.E.S., S.J.A.), Harvard Medical School, MA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David D.","family":"McManus","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Massachusetts Medical School, Worcester (D.D.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel E.","family":"Singer","sequence":"additional","affiliation":[{"name":"Division of General Internal Medicine (J.M.A., D.E.S., S.J.A.), Cardiac Arrhythmia Service, Massachusetts General Hospital, Boston."},{"name":"Department of Medicine (J.M.A., D.E.S., S.J.A.), Harvard Medical School, MA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven J.","family":"Atlas","sequence":"additional","affiliation":[{"name":"Division of General Internal Medicine (J.M.A., D.E.S., S.J.A.), Cardiac Arrhythmia Service, Massachusetts General Hospital, Boston."},{"name":"Department of Medicine (J.M.A., D.E.S., S.J.A.), Harvard Medical School, MA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4076-2336","authenticated-orcid":false,"given":"Emelia J.","family":"Benjamin","sequence":"additional","affiliation":[{"name":"Department of Medicine, Sections of Preventive Medicine and Cardiovascular Medicine (E.J.B.), Harvard Medical School, MA."},{"name":"Boston University and National Heart, Lung and Blood Institute\u2019s Framingham Heart Study (E.J.B.), Boston University School of Public Health, MA."},{"name":"Department of Epidemiology (E.J.B.), Boston University School of Public Health, MA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2067-0533","authenticated-orcid":false,"given":"Patrick T.","family":"Ellinor","sequence":"additional","affiliation":[{"name":"Cardiovascular Research Center (E.Y.W., O.L.H., S.K., L.-C.W., P.T.E.), Cardiac Arrhythmia Service, Massachusetts General Hospital, Boston."},{"name":"Cardiovascular Disease Initiative, The Broad Institute of Harvard and MIT, Cambridge, MA (S.K., L.-C.W., S.H.C., P.T.E., S.A.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ludovic","family":"Trinquart","sequence":"additional","affiliation":[{"name":"Department of Biostatistics (L.T.), Boston University School of Public Health, MA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9599-4866","authenticated-orcid":false,"given":"Steven A.","family":"Lubitz","sequence":"additional","affiliation":[{"name":"Division of Cardiology (S.K., S.A.L.), Cardiac Arrhythmia Service, Massachusetts General Hospital, Boston."},{"name":"Cardiovascular Disease Initiative, The Broad Institute of Harvard and MIT, Cambridge, MA (S.K., L.-C.W., S.H.C., P.T.E., S.A.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.113.005119"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.117.031431"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCEP.118.006350"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.117.028981"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.114.014058"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.164.15.1675"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1186\/1756-6614-2-4"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1136\/emermed-2012-202089"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jjcc.2016.12.013"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2015-307917"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2014.03.021"},{"key":"e_1_3_4_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2010.09.013"},{"key":"e_1_3_4_14_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.14-0003"},{"key":"e_1_3_4_15_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2011.1615"},{"key":"e_1_3_4_16_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2014.9143"},{"key":"e_1_3_4_17_2","doi-asserted-by":"publisher","DOI":"10.1111\/jocs.12033"},{"key":"e_1_3_4_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2009.10.058"},{"key":"e_1_3_4_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2018.03.003"},{"key":"e_1_3_4_20_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamacardio.2018.0405"},{"key":"e_1_3_4_21_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-018-4612-6"},{"key":"e_1_3_4_22_2","doi-asserted-by":"publisher","DOI":"10.1159\/000457809"},{"key":"e_1_3_4_23_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.15-0358"},{"key":"e_1_3_4_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2015.10.031"},{"key":"e_1_3_4_25_2","first-page":"1044","article-title":"Calculating the benefits of a research patient data repository.","volume":"2006","author":"Nalichowski R","year":"2006","unstructured":"Nalichowski, R, Keogh, D, Chueh, HC, Murphy, SN. Calculating the benefits of a research patient data repository. AMIA Annu Symp Proc. 2006;2006:1044.","journal-title":"AMIA Annu Symp Proc"},{"key":"e_1_3_4_26_2","doi-asserted-by":"publisher","DOI":"10.1093\/jamia\/ocw123"},{"key":"e_1_3_4_27_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.str.29.8.1602"},{"key":"e_1_3_4_28_2","unstructured":"Gray B. Cmprsk: Subdistribution Analysis of Competing Risks. R package version 2.2-7. 2014. Available at: https:\/\/CRAN.R-project.org\/package=cmprsk."},{"key":"e_1_3_4_29_2","doi-asserted-by":"publisher","DOI":"10.1080\/01621459.1999.10474144"},{"key":"e_1_3_4_30_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.112.000102"},{"key":"e_1_3_4_31_2","volume-title":"R: A language and environment for statistical computing","author":"R Core Team","year":"2017","unstructured":"R Core Team. 2017. R: A language and environment for statistical computing. R Vienna, Austria; Foundation for Statistical Computing. Available at: https:\/\/www.R-project.org\/."},{"key":"e_1_3_4_32_2","doi-asserted-by":"publisher","DOI":"10.1109\/TVCG.2014.2346248"},{"key":"e_1_3_4_33_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2011.03.038"},{"key":"e_1_3_4_34_2","doi-asserted-by":"publisher","DOI":"10.4037\/ajcc2003.12.5.424"},{"key":"e_1_3_4_35_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2008.10.019"},{"key":"e_1_3_4_36_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2013.12.010"},{"key":"e_1_3_4_37_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2007.07.044"},{"key":"e_1_3_4_38_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehn579"},{"key":"e_1_3_4_39_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacep.2017.08.003"}],"container-title":["Circulation: Arrhythmia and Electrophysiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/CIRCEP.119.007716","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,12]],"date-time":"2024-05-12T21:28:49Z","timestamp":1715549329000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/CIRCEP.119.007716"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,3]]},"references-count":38,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2020,3]]}},"alternative-id":["10.1161\/CIRCEP.119.007716"],"URL":"https:\/\/doi.org\/10.1161\/circep.119.007716","relation":{},"ISSN":["1941-3149","1941-3084"],"issn-type":[{"value":"1941-3149","type":"print"},{"value":"1941-3084","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,3]]},"assertion":[{"value":"2019-07-08","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-01-09","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-02-12","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e007716"}}