Detection of Subclinical Atrial Fibrillation in High-Risk Patients Using an Insertable Cardiac Monitor

JACC. Clinical Electrophysiology
Tine J PhilippsenAxel Brandes

Abstract

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. 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. 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. 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%) pat...Continue Reading

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Citations

Aug 5, 2019·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Emanuele BertagliaPaulus Kirchhof
Dec 18, 2020·Frontiers in Cardiovascular Medicine·Xianghong Meng, Xiaoyong Xu
Jun 5, 2021·Herz·Sebastian KönigGerhard Hindricks
Jul 20, 2021·International Heart Journal·Songqun HuangJiang Cao

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