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Prevalence and Incidence of Atrial Fibrillation in Heart Failure with Mildly Reduced or Preserved Ejection Fraction: (Additive) Value of Implantable Loop Recorders

Background: Atrial fibrillation (AF) is common in heart failure with mildly reduced or preserved ejection fraction (HFmrEF/HFpEF) and has a negative impact on outcome. Reliable data on prevalence, incidence, and detection of AF from contemporary, prospective HFmrEF/HFpEF studies are scarce. Methods:...

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Autores principales: Gorter, Thomas M., van Veldhuisen, Dirk J., Mulder, Bart A., Artola Arita, Vicente A., van Empel, Vanessa P. M., Manintveld, Olivier C., Tieleman, Robert G., Maass, Alexander H., Vernooy, Kevin, van Gelder, Isabelle C., Rienstra, Michiel
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10253837/
https://www.ncbi.nlm.nih.gov/pubmed/37297876
http://dx.doi.org/10.3390/jcm12113682
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author Gorter, Thomas M.
van Veldhuisen, Dirk J.
Mulder, Bart A.
Artola Arita, Vicente A.
van Empel, Vanessa P. M.
Manintveld, Olivier C.
Tieleman, Robert G.
Maass, Alexander H.
Vernooy, Kevin
van Gelder, Isabelle C.
Rienstra, Michiel
author_facet Gorter, Thomas M.
van Veldhuisen, Dirk J.
Mulder, Bart A.
Artola Arita, Vicente A.
van Empel, Vanessa P. M.
Manintveld, Olivier C.
Tieleman, Robert G.
Maass, Alexander H.
Vernooy, Kevin
van Gelder, Isabelle C.
Rienstra, Michiel
author_sort Gorter, Thomas M.
collection PubMed
description Background: Atrial fibrillation (AF) is common in heart failure with mildly reduced or preserved ejection fraction (HFmrEF/HFpEF) and has a negative impact on outcome. Reliable data on prevalence, incidence, and detection of AF from contemporary, prospective HFmrEF/HFpEF studies are scarce. Methods: This was a prespecified sub-analysis from a prospective, multicenter study. Patients with HFmrEF/HFpEF underwent 12-lead electrocardiography (ECG), 24 h Holter monitoring, and received an implantable loop recorder (ILR) at the study start. During the 2 year follow-up, rhythm monitoring was performed via ILR, yearly ECG, and two yearly 24 h Holter monitors. Results: A total of 113 patients were included (mean age 73 ± 8 years, 75% HFpEF). At baseline, 70 patients (62%) had a diagnosis of AF: 21 paroxysmal, 18 persistent, and 31 permanent AF. At study start, 45 patients were in AF. Of the 43 patients without a history of AF, 19 developed incident AF during a median follow-up of 23 [15–25] months (44%; incidence rate 27.1 (95% confidence interval 16.3–42.4) per 100 person-years). Thus, after the 2-year follow-up, 89 patients (79%) had a diagnosis of AF. In 11/19 incident AF cases (i.e., 58%), AF was solely detected on the ILR. Yearly 12-lead ECG detected six incident AF cases and four of these cases were also detected on two yearly 24 h Holter monitors. Two incident AF cases were detected on an unplanned ECG/Holter. Conclusions: Atrial fibrillation is extremely common in heart failure with HFmrEF/HFpEF and may inform on symptom evaluation and treatment options. AF screening with an ILR had a much higher diagnostic yield than conventional modalities.
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spelling pubmed-102538372023-06-10 Prevalence and Incidence of Atrial Fibrillation in Heart Failure with Mildly Reduced or Preserved Ejection Fraction: (Additive) Value of Implantable Loop Recorders Gorter, Thomas M. van Veldhuisen, Dirk J. Mulder, Bart A. Artola Arita, Vicente A. van Empel, Vanessa P. M. Manintveld, Olivier C. Tieleman, Robert G. Maass, Alexander H. Vernooy, Kevin van Gelder, Isabelle C. Rienstra, Michiel J Clin Med Article Background: Atrial fibrillation (AF) is common in heart failure with mildly reduced or preserved ejection fraction (HFmrEF/HFpEF) and has a negative impact on outcome. Reliable data on prevalence, incidence, and detection of AF from contemporary, prospective HFmrEF/HFpEF studies are scarce. Methods: This was a prespecified sub-analysis from a prospective, multicenter study. Patients with HFmrEF/HFpEF underwent 12-lead electrocardiography (ECG), 24 h Holter monitoring, and received an implantable loop recorder (ILR) at the study start. During the 2 year follow-up, rhythm monitoring was performed via ILR, yearly ECG, and two yearly 24 h Holter monitors. Results: A total of 113 patients were included (mean age 73 ± 8 years, 75% HFpEF). At baseline, 70 patients (62%) had a diagnosis of AF: 21 paroxysmal, 18 persistent, and 31 permanent AF. At study start, 45 patients were in AF. Of the 43 patients without a history of AF, 19 developed incident AF during a median follow-up of 23 [15–25] months (44%; incidence rate 27.1 (95% confidence interval 16.3–42.4) per 100 person-years). Thus, after the 2-year follow-up, 89 patients (79%) had a diagnosis of AF. In 11/19 incident AF cases (i.e., 58%), AF was solely detected on the ILR. Yearly 12-lead ECG detected six incident AF cases and four of these cases were also detected on two yearly 24 h Holter monitors. Two incident AF cases were detected on an unplanned ECG/Holter. Conclusions: Atrial fibrillation is extremely common in heart failure with HFmrEF/HFpEF and may inform on symptom evaluation and treatment options. AF screening with an ILR had a much higher diagnostic yield than conventional modalities. MDPI 2023-05-26 /pmc/articles/PMC10253837/ /pubmed/37297876 http://dx.doi.org/10.3390/jcm12113682 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Gorter, Thomas M.
van Veldhuisen, Dirk J.
Mulder, Bart A.
Artola Arita, Vicente A.
van Empel, Vanessa P. M.
Manintveld, Olivier C.
Tieleman, Robert G.
Maass, Alexander H.
Vernooy, Kevin
van Gelder, Isabelle C.
Rienstra, Michiel
Prevalence and Incidence of Atrial Fibrillation in Heart Failure with Mildly Reduced or Preserved Ejection Fraction: (Additive) Value of Implantable Loop Recorders
title Prevalence and Incidence of Atrial Fibrillation in Heart Failure with Mildly Reduced or Preserved Ejection Fraction: (Additive) Value of Implantable Loop Recorders
title_full Prevalence and Incidence of Atrial Fibrillation in Heart Failure with Mildly Reduced or Preserved Ejection Fraction: (Additive) Value of Implantable Loop Recorders
title_fullStr Prevalence and Incidence of Atrial Fibrillation in Heart Failure with Mildly Reduced or Preserved Ejection Fraction: (Additive) Value of Implantable Loop Recorders
title_full_unstemmed Prevalence and Incidence of Atrial Fibrillation in Heart Failure with Mildly Reduced or Preserved Ejection Fraction: (Additive) Value of Implantable Loop Recorders
title_short Prevalence and Incidence of Atrial Fibrillation in Heart Failure with Mildly Reduced or Preserved Ejection Fraction: (Additive) Value of Implantable Loop Recorders
title_sort prevalence and incidence of atrial fibrillation in heart failure with mildly reduced or preserved ejection fraction: (additive) value of implantable loop recorders
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10253837/
https://www.ncbi.nlm.nih.gov/pubmed/37297876
http://dx.doi.org/10.3390/jcm12113682
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