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Feasibility of Extended Ambulatory Electrocardiogram Monitoring to Identify Silent Atrial Fibrillation in High‐risk Patients: The Screening Study for Undiagnosed Atrial Fibrillation (STUDY‐AF)

BACKGROUND: Identification of silent atrial fibrillation (AF) could prevent stroke and other sequelae. HYPOTHESIS: Screening for AF using continuous ambulatory electrocardiographic (ECG) monitoring can detect silent AF in asymptomatic in patients with known risk factors. METHODS: We performed a sing...

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Autores principales: Turakhia, Mintu P., Ullal, Aditya J., Hoang, Donald D., Than, Claire T., Miller, Jared D., Friday, Karen J., Perez, Marco V., Freeman, James V., Wang, Paul J., Heidenreich, Paul A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wiley Periodicals, Inc. 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4654330/
https://www.ncbi.nlm.nih.gov/pubmed/25873476
http://dx.doi.org/10.1002/clc.22387
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author Turakhia, Mintu P.
Ullal, Aditya J.
Hoang, Donald D.
Than, Claire T.
Miller, Jared D.
Friday, Karen J.
Perez, Marco V.
Freeman, James V.
Wang, Paul J.
Heidenreich, Paul A.
author_facet Turakhia, Mintu P.
Ullal, Aditya J.
Hoang, Donald D.
Than, Claire T.
Miller, Jared D.
Friday, Karen J.
Perez, Marco V.
Freeman, James V.
Wang, Paul J.
Heidenreich, Paul A.
author_sort Turakhia, Mintu P.
collection PubMed
description BACKGROUND: Identification of silent atrial fibrillation (AF) could prevent stroke and other sequelae. HYPOTHESIS: Screening for AF using continuous ambulatory electrocardiographic (ECG) monitoring can detect silent AF in asymptomatic in patients with known risk factors. METHODS: We performed a single‐center prospective screening study using a wearable patch‐based device that provides up to 2 weeks of continuous ambulatory ECG monitoring (iRhythm Technologies, Inc.). Inclusion criteria were age ≥55 years and ≥2 of the following risk factors: coronary disease, heart failure, hypertension, diabetes, sleep apnea. We excluded patients with prior AF, stroke, transient ischemic attack, implantable pacemaker or defibrillator, or with palpitations or syncope in the prior year. RESULTS: Out of 75 subjects (all male, age 69 ± 8.0 years; ejection fraction 57% ± 8.7%), AF was detected in 4 subjects (5.3%; AF burden 28% ± 48%). Atrial tachycardia (AT) was present in 67% (≥4 beats), 44% (≥8 beats), and 6.7% (≥60 seconds) of subjects. The combined diagnostic yield of sustained AT/AF was 11%. In subjects without sustained AT/AF, 11 (16%) had ≥30 supraventricular ectopic complexes per hour. CONCLUSIONS: Outpatient extended ECG screening for asymptomatic AF is feasible, with AF identified in 1 in 20 subjects and sustained AT/AF identified in 1 in 9 subjects, respectively. We also found a high prevalence of asymptomatic AT and frequent supraventricular ectopic complexes, which may be relevant to development of AF or stroke. If confirmed in a larger study, primary screening for AF could have a significant impact on public health.
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spelling pubmed-46543302015-11-27 Feasibility of Extended Ambulatory Electrocardiogram Monitoring to Identify Silent Atrial Fibrillation in High‐risk Patients: The Screening Study for Undiagnosed Atrial Fibrillation (STUDY‐AF) Turakhia, Mintu P. Ullal, Aditya J. Hoang, Donald D. Than, Claire T. Miller, Jared D. Friday, Karen J. Perez, Marco V. Freeman, James V. Wang, Paul J. Heidenreich, Paul A. Clin Cardiol Clinical Investigations BACKGROUND: Identification of silent atrial fibrillation (AF) could prevent stroke and other sequelae. HYPOTHESIS: Screening for AF using continuous ambulatory electrocardiographic (ECG) monitoring can detect silent AF in asymptomatic in patients with known risk factors. METHODS: We performed a single‐center prospective screening study using a wearable patch‐based device that provides up to 2 weeks of continuous ambulatory ECG monitoring (iRhythm Technologies, Inc.). Inclusion criteria were age ≥55 years and ≥2 of the following risk factors: coronary disease, heart failure, hypertension, diabetes, sleep apnea. We excluded patients with prior AF, stroke, transient ischemic attack, implantable pacemaker or defibrillator, or with palpitations or syncope in the prior year. RESULTS: Out of 75 subjects (all male, age 69 ± 8.0 years; ejection fraction 57% ± 8.7%), AF was detected in 4 subjects (5.3%; AF burden 28% ± 48%). Atrial tachycardia (AT) was present in 67% (≥4 beats), 44% (≥8 beats), and 6.7% (≥60 seconds) of subjects. The combined diagnostic yield of sustained AT/AF was 11%. In subjects without sustained AT/AF, 11 (16%) had ≥30 supraventricular ectopic complexes per hour. CONCLUSIONS: Outpatient extended ECG screening for asymptomatic AF is feasible, with AF identified in 1 in 20 subjects and sustained AT/AF identified in 1 in 9 subjects, respectively. We also found a high prevalence of asymptomatic AT and frequent supraventricular ectopic complexes, which may be relevant to development of AF or stroke. If confirmed in a larger study, primary screening for AF could have a significant impact on public health. Wiley Periodicals, Inc. 2015-04-14 /pmc/articles/PMC4654330/ /pubmed/25873476 http://dx.doi.org/10.1002/clc.22387 Text en © 2015 The Authors. Clinical Cardiology published by Wiley Periodicals, Inc. This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Clinical Investigations
Turakhia, Mintu P.
Ullal, Aditya J.
Hoang, Donald D.
Than, Claire T.
Miller, Jared D.
Friday, Karen J.
Perez, Marco V.
Freeman, James V.
Wang, Paul J.
Heidenreich, Paul A.
Feasibility of Extended Ambulatory Electrocardiogram Monitoring to Identify Silent Atrial Fibrillation in High‐risk Patients: The Screening Study for Undiagnosed Atrial Fibrillation (STUDY‐AF)
title Feasibility of Extended Ambulatory Electrocardiogram Monitoring to Identify Silent Atrial Fibrillation in High‐risk Patients: The Screening Study for Undiagnosed Atrial Fibrillation (STUDY‐AF)
title_full Feasibility of Extended Ambulatory Electrocardiogram Monitoring to Identify Silent Atrial Fibrillation in High‐risk Patients: The Screening Study for Undiagnosed Atrial Fibrillation (STUDY‐AF)
title_fullStr Feasibility of Extended Ambulatory Electrocardiogram Monitoring to Identify Silent Atrial Fibrillation in High‐risk Patients: The Screening Study for Undiagnosed Atrial Fibrillation (STUDY‐AF)
title_full_unstemmed Feasibility of Extended Ambulatory Electrocardiogram Monitoring to Identify Silent Atrial Fibrillation in High‐risk Patients: The Screening Study for Undiagnosed Atrial Fibrillation (STUDY‐AF)
title_short Feasibility of Extended Ambulatory Electrocardiogram Monitoring to Identify Silent Atrial Fibrillation in High‐risk Patients: The Screening Study for Undiagnosed Atrial Fibrillation (STUDY‐AF)
title_sort feasibility of extended ambulatory electrocardiogram monitoring to identify silent atrial fibrillation in high‐risk patients: the screening study for undiagnosed atrial fibrillation (study‐af)
topic Clinical Investigations
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4654330/
https://www.ncbi.nlm.nih.gov/pubmed/25873476
http://dx.doi.org/10.1002/clc.22387
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