Detection of Subclinical Atrial Fibrillation in High-Risk Patients Using an Insertable Cardiac Monitor
| Autor: | Jordi S. Dahl, Tine Jensen Philippsen, Lene Svendstrup Christensen, Michael Gilså Hansen, Axel Brandes |
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| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
Male
medicine.medical_specialty arterial hypertension 030204 cardiovascular system & hematology Asymptomatic 03 medical and health sciences 0302 clinical medicine Interquartile range Risk Factors Hypertension/epidemiology Thromboembolism Internal medicine Diabetes mellitus Atrial Fibrillation Electrocardiography Ambulatory/methods Diabetes Mellitus medicine Clinical endpoint Implantable loop recorder Atrial Fibrillation/diagnosis Humans atrial fibrillation 030212 general & internal medicine Prospective Studies insertable cardiac monitor Subclinical infection Aged Thromboembolism/epidemiology business.industry Incidence (epidemiology) screening Incidence Atrial fibrillation medicine.disease Hypertension diabetes mellitus Electrocardiography Ambulatory Cardiology Diabetes Mellitus/epidemiology Female medicine.symptom business Follow-Up Studies |
| Zdroj: | Philippsen, T J, Christensen, L S, Hansen, M G, Dahl, J & Brandes, A 2017, ' Detection of Subclinical Atrial Fibrillation in High-Risk Patients Using an Insertable Cardiac Monitor ', J A C C: Clinical Electrophysiology, vol. 3, no. 13, pp. 1557-1564 . https://doi.org/10.1016/j.jacep.2017.06.020 |
| DOI: | 10.1016/j.jacep.2017.06.020 |
| Popis: | Objectives The study sought to determine the incidence of subclinical atrial fibrillation (AF) in high-risk patients and to compare the effect of continuous versus intermittent monitoring. Background AF often occurs in a subclinical form, which makes it difficult to detect. The authors do not know the incidence of subclinical AF among patients ≥65 years of age with hypertension and diabetes mellitus. This group of patients has increased risk of developing AF and in addition a high thromboembolic risk, if AF is present. Methods A total of 82 outpatients ≥65 years of age (median age 71.3 years [interquartile range [IQR]: 67.4 to 75.1 years]) with hypertension and diabetes mellitus, and no history of AF or any other cardiovascular disease, were consecutively included. All patients received an insertable cardiac monitor (ICM) and were followed for a median of 588 days (IQR: 453 to 712 days). We compared continuous monitoring with 72-h Holter monitoring 1 month after ICM insertion. The primary endpoint was AF ≥2 min for the ICM and AF ≥30 s for the Holter monitoring. Results During follow-up 17 (20.7%) patients were found to have subclinical AF detected by ICM with a median time to first detected episode of 91 days (IQR: 41 to 251 days) from inclusion. Only 2 (2.4%) patients also had AF episodes on the 72-h Holter monitoring. All detected episodes were completely asymptomatic. Conclusions The incidence of subclinical AF in this group of patients was surprisingly high. Continuous monitoring with ICM detected significantly more AF episodes than 72-h Holter monitoring. (Detection of Subclinical Atrial Fibrillation in High Risk Patients Using Implantable Loop Recorder; NCT02041832). |
| Databáze: | OpenAIRE |
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