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Estimated incidence of previously undetected atrial fibrillation on a 14-day continuous electrocardiographic monitor and associated risk of stroke.
In: EP: Europace, Jg. 24 (2022-07-01), Heft 7, S. 1058-1064
Online
academicJournal
Zugriff:
Aims: There is uncertainty about whether and how to perform screening for atrial fibrillation (AF). To estimate the incidence of previously undetected AF that would be captured using a continuous 14-day ECG monitor and the associated risk of stroke. Methods and Results: We analysed data from a cohort of patients >65 years old with hypertension and a pacemaker, but without known AF. For each participant, we simulated 1000 ECG monitors by randomly selecting 14-day windows in the 6 months following enrolment and calculated the average AF burden (total time in AF). We used Cox proportional hazards models adjusted for CHA2DS2-VASc score to estimate the risk of subsequent ischaemic stroke or systemic embolism (SSE) associated with burdens of AF > and <6 min. Among 2470 participants, the median CHA2DS2-VASc score was 4.0, and 44 patients experienced SSE after 6 months following enrolment. The proportion of participants with an AF burden >6 min was 3.10% (95% CI 2.53-3.72). This was consistent across strata of age and CHA2DS2-VASc scores. Over a mean follow-up of 2.4 years, the rate of SSE among patients with <6 min of AF was 0.70%/year, compared to 2.18%/year (adjusted HR 3.02; 95% CI 1.39-6.56) in those with >6 min of AF. Conclusions: Approximately 3% of individuals aged >65 years with hypertension may have more than 6 min of AF detected by a 14-day ECG monitor. This is associated with a stroke risk of over 2% per year. Whether oral anticoagulation will reduce stroke in these patients is unknown. [ABSTRACT FROM AUTHOR]
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Titel: |
Estimated incidence of previously undetected atrial fibrillation on a 14-day continuous electrocardiographic monitor and associated risk of stroke.
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Autor/in / Beteiligte Person: | McIntyre, William F ; Wang, Jia ; Benz, Alexander P ; Johnson, Linda ; Connolly, Stuart J ; Gelder, Isabelle C Van ; Lopes, Renato D ; Gold, Michael R ; Hohnloser, Stefan H ; Lau, Chu Pak ; Israel, Carsten W ; Wong, Jorge A ; Conen, David ; Healey, Jeff S ; Van Gelder, Isabelle C |
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Zeitschrift: | EP: Europace, Jg. 24 (2022-07-01), Heft 7, S. 1058-1064 |
Veröffentlichung: | 2022 |
Medientyp: | academicJournal |
ISSN: | 1099-5129 (print) |
DOI: | 10.1093/europace/euab324 |
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