{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T19:56:38Z","timestamp":1787169398593,"version":"build-2736575974"},"reference-count":44,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2023,1,18]],"date-time":"2023-01-18T00:00:00Z","timestamp":1674000000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Paroxysmal atrial fibrillation (AF) may often progress towards more sustained forms of the arrhythmia, but further research is needed on the factors associated with this clinical course. Methods: We analyzed patients enrolled in a prospective cohort study of AF patients. Patients with paroxysmal AF at baseline or first-detected AF (with successful cardioversion) were included. According to rhythm status at 1 year, patients were stratified into: (i) No AF progression and (ii) AF progression. All-cause death was the primary outcome. Results: A total of 2688 patients were included (median age 67 years, interquartile range 60\u201375, females 44.7%). At 1-year of follow-up, 2094 (77.9%) patients showed no AF progression, while 594 (22.1%) developed persistent or permanent AF. On multivariable logistic regression analysis, no physical activity (odds ratio [OR] 1.35, 95% CI 1.02\u20131.78), valvular heart disease (OR 1.63, 95% CI 1.23\u20132.15), left atrial diameter (OR 1.03, 95% CI 1.01\u20131.05), or left ventricular ejection fraction (OR 0.98, 95% CI 0.97\u20131.00) were independently associated with AF progression at 1 year. After the assessment at 1 year, the patients were followed for an extended follow-up of 371 days, and those with AF progression were independently associated with a higher risk for all-cause death (adjusted hazard ratio 1.77, 95% CI 1.09\u20132.89) compared to no-AF-progression patients. Conclusions: In a contemporary cohort of AF patients, a substantial proportion of patients presenting with paroxysmal or first-detected AF showed progression of the AF pattern within 1 year, and clinical factors related to cardiac remodeling were associated with progression. AF progression was associated with an increased risk of all-cause mortality.<\/jats:p>","DOI":"10.3390\/jcm12030768","type":"journal-article","created":{"date-parts":[[2023,1,19]],"date-time":"2023-01-19T05:50:20Z","timestamp":1674107420000},"page":"768","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Factors Associated with Progression of Atrial Fibrillation and Impact on All-Cause Mortality in a Cohort of European Patients"],"prefix":"10.3390","volume":"12","author":[{"given":"Marco","family":"Vitolo","sequence":"first","affiliation":[{"name":"Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, 41124 Modena, Italy"},{"name":"Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University, Liverpool Heart & Chest Hospital, Liverpool L14 3PE, UK"},{"name":"Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, 41125 Modena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1452-2478","authenticated-orcid":false,"given":"Marco","family":"Proietti","sequence":"additional","affiliation":[{"name":"Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University, Liverpool Heart & Chest Hospital, Liverpool L14 3PE, UK"},{"name":"Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy"},{"name":"Geriatric Unit, IRCCS Istituti Clinici Scientifici Maugeri, 20138 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacopo F.","family":"Imberti","sequence":"additional","affiliation":[{"name":"Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, 41124 Modena, Italy"},{"name":"Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University, Liverpool Heart & Chest Hospital, Liverpool L14 3PE, UK"},{"name":"Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, 41125 Modena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niccol\u00f2","family":"Bonini","sequence":"additional","affiliation":[{"name":"Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, 41124 Modena, Italy"},{"name":"Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University, Liverpool Heart & Chest Hospital, Liverpool L14 3PE, UK"},{"name":"Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, 41125 Modena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3788-8942","authenticated-orcid":false,"given":"Giulio Francesco","family":"Romiti","sequence":"additional","affiliation":[{"name":"Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University, Liverpool Heart & Chest Hospital, Liverpool L14 3PE, UK"},{"name":"Department of Translational and Precision Medicine, Sapienza\u2014University of Rome, 00185 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Davide A.","family":"Mei","sequence":"additional","affiliation":[{"name":"Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, 41124 Modena, Italy"},{"name":"Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University, Liverpool Heart & Chest Hospital, Liverpool L14 3PE, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincenzo L.","family":"Malavasi","sequence":"additional","affiliation":[{"name":"Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, 41124 Modena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3823-3809","authenticated-orcid":false,"given":"Igor","family":"Diemberger","sequence":"additional","affiliation":[{"name":"Department of Experimental, Diagnostic and Specialty Medicine, Institute of Cardiology, University of Bologna, Policlinico S. Orsola-Malpighi, 40138 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9267-1658","authenticated-orcid":false,"given":"Laurent","family":"Fauchier","sequence":"additional","affiliation":[{"name":"Service de Cardiologie, Centre Hospitalier Universitaire Trousseau, 37000 Tours, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7246-7708","authenticated-orcid":false,"given":"Francisco","family":"Marin","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Hospital Universitario Virgen de la Arrixaca, IMIB-Arrixaca, University of Murcia, CIBERCV, 30100 Murcia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5893-7478","authenticated-orcid":false,"given":"Michael","family":"Nabauer","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Ludwig-Maximilians-University, 80539 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6285-6902","authenticated-orcid":false,"given":"Tatjana S.","family":"Potpara","sequence":"additional","affiliation":[{"name":"School of Medicine, University of Belgrade, 11000 Belgrade, Serbia"},{"name":"Intensive Arrhythmia Care, Cardiology Clinic, Clinical Center of Serbia, 11000 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gheorghe-Andrei","family":"Dan","sequence":"additional","affiliation":[{"name":"\u2018Carol Davila\u2019 University of Medicine, Colentina University Hospital, 020125 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7566-1626","authenticated-orcid":false,"given":"Gregory Y. H.","family":"Lip","sequence":"additional","affiliation":[{"name":"Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University, Liverpool Heart & Chest Hospital, Liverpool L14 3PE, UK"},{"name":"Department of Clinical Medicine, Aalborg University, 9220 Aalborg, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9820-4815","authenticated-orcid":false,"given":"Giuseppe","family":"Boriani","sequence":"additional","affiliation":[{"name":"Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, 41124 Modena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,1,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1093\/cvr\/cvab147","article-title":"Optimizing indices of atrial fibrillation susceptibility and burden to evaluate atrial fibrillation severity, risk and outcomes","volume":"117","author":"Boriani","year":"2021","journal-title":"Cardiovasc. Res."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.ejim.2021.01.006","article-title":"Beyond the 2020 guidelines on atrial fibrillation of the European society of cardiology","volume":"86","author":"Boriani","year":"2021","journal-title":"Eur. J. Intern. Med."},{"key":"ref_3","first-page":"270","article-title":"The 4S-AF Scheme (Stroke Risk; Symptoms; Severity of Burden; Substrate): A Novel Approach to In-Depth Characterization (Rather than Classification) of Atrial Fibrillation","volume":"121","author":"Potpara","year":"2020","journal-title":"Thromb. Haemost."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1093\/eurheartj\/ehaa612","article-title":"2020 ESC Guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS): The Task Force for the diagnosis and management of atrial fibrillation of the European Society of Cardiology (ESC) Developed with the special contribution of the European Heart Rhythm Association (EHRA) of the ESC","volume":"42","author":"Hindricks","year":"2021","journal-title":"Eur. Heart J."},{"key":"ref_5","first-page":"352","article-title":"Atrial fibrillation progression risk factors and associated cardiovascular outcome in well-phenotyped patients: Data from the AF-RISK study","volume":"22","author":"Marcos","year":"2019","journal-title":"Europace"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"3541","DOI":"10.1093\/eurheartj\/ehab453","article-title":"Prevalence, management and impact of chronic obstructive pulmonary disease in atrial fibrillation: A systematic review and meta-analysis of 4,200,000 patients","volume":"42","author":"Romiti","year":"2021","journal-title":"Eur. Heart J."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"502","DOI":"10.1016\/j.hrthm.2018.10.022","article-title":"Incidence and predictors of atrial fibrillation progression: A systematic review and meta-analysis","volume":"16","author":"Blum","year":"2018","journal-title":"Heart Rhythm."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1016\/j.ccep.2020.10.011","article-title":"Risk Factors for Atrial Fibrillation Progression","volume":"13","author":"Heijman","year":"2021","journal-title":"Card. Electrophysiol. Clin."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1183","DOI":"10.1007\/s11739-020-02405-0","article-title":"The Euro Heart Survey and EURObservational Research Programme (EORP) in atrial fibrillation registries: Contribution to epidemiology, clinical management and therapy of atrial fibrillation patients over the last 20 years","volume":"15","author":"Vitolo","year":"2020","journal-title":"Intern. Emerg. Med."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"747","DOI":"10.1093\/europace\/eux301","article-title":"Contemporary stroke prevention strategies in 11 096 European patients with atrial fibrillation: A report from the EURObservational Research Programme on Atrial Fibrillation (EORP-AF) Long-Term General Registry","volume":"20","author":"Boriani","year":"2017","journal-title":"Europace"},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Proietti, M., Vitolo, M., Harrison, S.L., Lane, D.A., Fauchier, L., Marin, F., Nabauer, M., Potpara, T.S., Dan, G.-A., and Boriani, G. (2021). Impact of clinical phenotypes on management and outcomes in European atrial fibrillation patients: A report from the ESC-EHRA EURObservational Research Programme in AF (EORP-AF) General Long-Term Registry. BMC Med., 19.","DOI":"10.1186\/s12916-021-02120-3"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1378\/chest.09-1584","article-title":"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","volume":"137","author":"Lip","year":"2010","journal-title":"Chest"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"778","DOI":"10.1093\/ehjqcco\/qcab069","article-title":"Comparison of HAS-BLED and ORBIT Bleeding Risk Scores in AF Patients treated with NOACs: A Report from the ESC-EHRA EORP-AF General Long-Term Registry","volume":"8","author":"Proietti","year":"2021","journal-title":"Eur. Heart J.-Qual. Care Clin. Outcomes"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"2369","DOI":"10.1093\/eurheartj\/ehq278","article-title":"Guidelines for the management of atrial fibrillation: The Task Force for the Management of Atrial Fibrillation of the European Society of Cardiology (ESC)","volume":"31","author":"Camm","year":"2010","journal-title":"Eur. Heart J."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1954","DOI":"10.1161\/01.CIR.92.7.1954","article-title":"Atrial Fibrillation Begets Atrial Fibrillation. A study in awake chronically instrumented goats","volume":"92","author":"Wijffels","year":"1995","journal-title":"Circulation"},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Nguyen, B.-O., Weberndorfer, V., Crijns, H.J., Geelhoed, B., Cate, H.T., Spronk, H., Kroon, A., De With, R., Al-Jazairi, M., and Maass, A.H. (2022). Prevalence and determinants of atrial fibrillation progression in paroxysmal atrial fibrillation. Heart, epub ahead of print.","DOI":"10.1136\/heartjnl-2022-321027"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"e012554","DOI":"10.1161\/JAHA.119.012554","article-title":"Incidence and Predictors of Atrial Fibrillation Progression","volume":"8","author":"Blum","year":"2019","journal-title":"J. Am. Heart Assoc."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"725","DOI":"10.1016\/j.jacc.2009.11.040","article-title":"Progression From Paroxysmal to Persistent Atrial Fibrillation: Clinical Correlates and Prognosis","volume":"55","author":"Pisters","year":"2010","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"801","DOI":"10.1016\/j.hrthm.2017.01.038","article-title":"Progression of paroxysmal to persistent atrial fibrillation: 10-year follow-up in the Canadian Registry of Atrial Fibrillation","volume":"14","author":"Padfield","year":"2017","journal-title":"Heart Rhythm."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"359","DOI":"10.2459\/JCM.0000000000001316","article-title":"Atrial cardiomyopathy: A derangement in atrial volumes, geometry, function, and pathology with important clinical implications","volume":"23","author":"Boriani","year":"2022","journal-title":"J. Cardiovasc. Med."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1608","DOI":"10.1136\/heartjnl-2017-312569","article-title":"Atrial fibrillation patterns are associated with arrhythmia progression and clinical outcomes","volume":"104","author":"Schnabel","year":"2018","journal-title":"Heart"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1131","DOI":"10.1007\/s11739-020-02551-5","article-title":"Atrial fibrillation pattern and factors affecting the progression to permanent atrial fibrillation","volume":"16","author":"Malavasi","year":"2020","journal-title":"Intern. Emerg. Med."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"339","DOI":"10.1378\/chest.11-0340","article-title":"A 12-year follow-up study of patients with newly diagnosed lone atrial fibrillation: Implications of arrhythmia progression on prognosis: The Belgrade Atrial Fibrillation study","volume":"141","author":"Potpara","year":"2012","journal-title":"Chest"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"2301","DOI":"10.1161\/STROKEAHA.118.021396","article-title":"Progression From Paroxysmal to Sustained Atrial Fibrillation Is Associated With Increased Adverse Events","volume":"49","author":"Ogawa","year":"2018","journal-title":"Stroke"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"19224","DOI":"10.1038\/s41598-020-75822-y","article-title":"Association between clustering of unhealthy lifestyle factors and risk of new-onset atrial fibrillation: A nationwide population-based study","volume":"10","author":"Lee","year":"2020","journal-title":"Sci. Rep."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"H1051","DOI":"10.1152\/ajpheart.00509.2020","article-title":"The counterintuitive role of exercise in the prevention and cause of atrial fibrillation","volume":"319","author":"Buckley","year":"2020","journal-title":"Am. J. Physiol. Circ. Physiol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"467","DOI":"10.1016\/j.ijcard.2014.09.104","article-title":"Physical activity and incidence of atrial fibrillation: A systematic review and meta-analysis","volume":"177","author":"Kwok","year":"2014","journal-title":"Int. J. Cardiol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"13270","DOI":"10.1038\/s41598-019-49686-w","article-title":"Physical Activity and Risk of Atrial Fibrillation: A Nationwide Cohort Study in General Population","volume":"9","author":"Jin","year":"2019","journal-title":"Sci. Rep."},{"key":"ref_29","first-page":"535","article-title":"Self-reported physical activity and major adverse events in patients with atrial fibrillation: A report from the EURObservational Research Programme Pilot Survey on Atrial Fibrillation (EORP-AF) General Registry","volume":"19","author":"Proietti","year":"2016","journal-title":"Europace"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1750","DOI":"10.1093\/europace\/euy028","article-title":"Atrial fibrillation progression and outcome in patients with young-onset atrial fibrillation","volume":"20","author":"Marcos","year":"2018","journal-title":"Europace"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1016\/j.ejim.2021.05.038","article-title":"Device-detected atrial high rate episodes and the risk of stroke\/thrombo-embolism and atrial fibrillation incidence: A systematic review and meta-analysis","volume":"92","author":"Vitolo","year":"2021","journal-title":"Eur. J. Intern. Med."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"558","DOI":"10.1001\/jamacardio.2018.1205","article-title":"When Low-Risk Atrial Fibrillation Is Not So Low Risk","volume":"3","author":"Steinberg","year":"2018","journal-title":"JAMA Cardiol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"O42","DOI":"10.1093\/eurheartj\/suaa179","article-title":"What do we do about atrial high rate episodes?","volume":"22","author":"Boriani","year":"2020","journal-title":"Eur. Heart J. Suppl."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1119","DOI":"10.33963\/KP.15110","article-title":"Atrial fibrillation in patients with cardiac implantable electronic devices: New perspectives with important clinical implications","volume":"77","author":"Boriani","year":"2019","journal-title":"Kardiologia Polska"},{"key":"ref_35","first-page":"406","article-title":"Adherence to the \u2018Atrial Fibrillation Better Care\u2019 Pathway in Patients with Atrial Fibrillation: Impact on Clinical Outcomes\u2014A Systematic Review and Meta-Analysis of 285,000 Patients","volume":"122","author":"Romiti","year":"2021","journal-title":"Thromb. Haemost."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1016\/j.ejim.2022.08.004","article-title":"Adherence to the \u201cAtrial fibrillation Better Care\u201d (ABC) pathway in patients with atrial fibrillation and cancer: A report from the ESC-EHRA EURObservational Research Programme in atrial fibrillation (EORP-AF) General Long-Term Registry","volume":"105","author":"Vitolo","year":"2022","journal-title":"Eur. J. Intern. Med."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"e13751","DOI":"10.1111\/eci.13751","article-title":"4S-AF scheme and ABC pathway guided management improves outcomes in atrial fibrillation patients","volume":"52","author":"Guo","year":"2022","journal-title":"Eur. J. Clin. Investig."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1932","DOI":"10.1016\/j.jacc.2022.03.337","article-title":"The Increasing Role of Rhythm Control in Patients With Atrial Fibrillation: JACC State-of-the-Art Review","volume":"79","author":"Camm","year":"2022","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1007\/s00392-021-01914-y","article-title":"Real-world applicability and impact of early rhythm control for European patients with atrial fibrillation: A report from the ESC-EHRA EORP-AF Long-Term General Registry","volume":"111","author":"Proietti","year":"2021","journal-title":"Clin. Res. Cardiol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1305","DOI":"10.1056\/NEJMoa2019422","article-title":"Early Rhythm-Control Therapy in Patients with Atrial Fibrillation","volume":"383","author":"Kirchhof","year":"2020","journal-title":"N. Engl. J. Med."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1630","DOI":"10.1136\/heartjnl-2021-319496","article-title":"Catheter ablation as first-line treatment for paroxysmal atrial fibrillation: A systematic review and meta-analysis","volume":"107","author":"Imberti","year":"2021","journal-title":"Heart"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1016\/j.jacep.2015.04.010","article-title":"A Systematic Review on the Progression of Paroxysmal to Persistent Atrial Fibrillation: Shedding New Light on the Effects of Catheter Ablation","volume":"1","author":"Proietti","year":"2015","journal-title":"JACC Clin. Electrophysiol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"1001","DOI":"10.1007\/s11739-021-02890-x","article-title":"Rhythm- or rate-control strategies according to 4S-AF characterization scheme and long-term outcomes in atrial fibrillation patients: The FAMo (Fibrillazione Atriale in Modena) cohort","volume":"17","author":"Malavasi","year":"2021","journal-title":"Intern. Emerg. Med."},{"key":"ref_44","doi-asserted-by":"crossref","unstructured":"Andrade, J.G., Deyell, M.W., Macle, L., Wells, G.A., Bennett, M., Essebag, V., Champagne, J., Roux, J.-F., Yung, D., and Skanes, A. (2022). Progression of Atrial Fibrillation after Cryoablation or Drug Therapy. N. Engl. J. Med.","DOI":"10.1056\/NEJMoa2212540"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/3\/768\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T18:09:17Z","timestamp":1760119757000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/3\/768"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,1,18]]},"references-count":44,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2023,2]]}},"alternative-id":["jcm12030768"],"URL":"https:\/\/doi.org\/10.3390\/jcm12030768","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,1,18]]}}}