Arrhythmias & electrophysiology
Atrial cardiomyopathy as a multidomain disease: longitudinal evidence for autonomic remodelling
Main finding · Incident AFResult — go to the resultHazard ratio 2.43 95% CI 1.72–3.45Authors' conclusion
Atrial cardiomyopathy is a cumulative, multidomain disease process in which structural, electrical, and autonomic abnormalities define atrial disease burden. Longitudinal autonomic remodelling constitutes an independent and evolving axis within this framework
Study context
- Population
- Individuals aged 65 years without prior atrial fibrillation (AF) or major CVD, PROOF cohort, 24-h Holter ECGs at baseline and 5 years
- Participants
- 670 individuals
- Exposure
- ≥2 atrial remodelling domains vs fewer
- Outcome
- Incident AF and CV outcomes
- Follow-up
- Median 12.1 years
Main finding
Incident AF
Hazard ratio
2.43
95% CI 1.72–3.45
≥2 atrial remodelling domains (structural, electrical, autonomic)vs fewer
HR 2.43 (95% CI 1.72–3.45)
As reported in the abstract
- Participants who developed AF
- 72 (10.7%)
Observational data: associations, not effects.
Further findings
| Outcome | HR |
|---|---|
| MACE and all-cause mortality≥2 domains · MACE | 1.42 |
| MACE and all-cause mortality≥2 domains · all-cause mortality | 1.35 |
Original publication
Atrial cardiomyopathy as a multidomain disease: longitudinal evidence for autonomic remodelling. Europace. Published 30 June 2026. doi:10.
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