Estimated incidence of previously undetected atrial fibrillation on a 14-day continuous electrocardiographic monitor and associated risk of stroke
| Autor: | William F McIntyre, Jia Wang, Alexander P Benz, Linda Johnson, Stuart J Connolly, Isabelle C Van Gelder, Renato D Lopes, Michael R Gold, Stefan H Hohnloser, Chu Pak Lau, Carsten W Israel, Jorge A Wong, David Conen, Jeff S Healey |
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| Přispěvatelé: | Cardiovascular Centre (CVC) |
| Jazyk: | angličtina |
| Rok vydání: | 2022 |
| Předmět: |
Holter monitor
STRATEGIES ADHESIVE PATCH LONG-TERM Oral anticoagulation RATIONALE HIGH-RATE EPISODES INSERTABLE CARDIAC MONITORS DEVICE Risk Assessment Brain Ischemia Electrocardiography DESIGN Risk Factors Physiology (medical) Humans Aged ORAL ANTICOAGULANTS Incidence THROMBOEMBOLIC EVENTS Anticoagulants Atrial fibrillation Stroke Hypertension Screening Cardiology and Cardiovascular Medicine Simulation |
| Zdroj: | Europace, 24(7), 1058-1064. Oxford University Press |
| ISSN: | 1099-5129 |
| Popis: | 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 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. 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. |
| Databáze: | OpenAIRE |
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