Giuseppe Boriani1, Taya V Glotzer2, Paul D Ziegler3, Mirko De Melis4, Lorenza Mangoni di S Stefano5, Milan Sepsi6, Maurizio Landolina7, Maurizio Lunati8, Thorsten Lewalter9, A John Camm10. 1. Cardiology Division, Department of Diagnostics, Clinical and Public Health Medicine, University of Modena and Reggio Emilia, Policlinico di Modena, Modena, Italy. Electronic address: giuseppe.boriani@unimore.it. 2. Hackensak University Medical Center, Hackensack, New Jersey. 3. Medtronic, Minneapolis, Minnesota. 4. Medtronic Bakken Research Center, Maastricht, The Netherlands. 5. Medtronic EMEA Regional Clinical Center, Rome, Italy. 6. Department of Internal Medicine-Cardiology, University Hospital Brno, Brno, Czech Republic. 7. Ospedale Maggiore, Cremona, Italy. 8. Niguarda Ca' Granda Hospital, Milan, Italy. 9. Isar Heart Center Munich, Munich, Germany. 10. Molecular and Clinical Sciences Research Institute, St. George's University of London, London, United Kingdom.
Abstract
BACKGROUND: In patients with cardiac implanted electronic devices, detection of new atrial fibrillation (AF) is associated with an increased risk of stroke. OBJECTIVE: To characterize daily AF burden at first detection and the rate of temporal transition to higher device-detected AF burden. METHODS: A pooled analysis of data from 3 prospective projects was analyzed, and 6580 patients (mean age 68 ± 12 years, 72% male) with no history of AF and no use of anticoagulants at baseline were identified. Various thresholds of daily AF burden (5 minutes and 1, 6, 12, and 23 hours) were analyzed. RESULTS: Among the study population of 6580 patients, a new AF, with an AF burden of ≥5 minutes, was detected in 2244 patients (34%) during a follow-up period of 2.4 ± 1.7 years. Among these patients, 1091 (49.8%) transitioned to a higher AF-burden threshold during follow-up. A higher duration of daily AF burden manifest at first detection and CHADS2 score ≥2 were associated with faster transition to a subsequent higher burden. Approximately 24% of patients transitioned from a lower threshold to a daily AF burden of ≥23 hours during follow-up. CONCLUSION: More than one-third of patients with no history of AF developed device-detected AF, with attainment of different thresholds of daily AF burden over time. Continuous long-term monitoring, especially when the initial detection corresponds to a higher daily AF burden and the CHADS2 score is ≥2, could support timely clinical decisions on anticoagulation by capturing transitions to higher AF-burden thresholds.
BACKGROUND: In patients with cardiac implanted electronic devices, detection of new atrial fibrillation (AF) is associated with an increased risk of stroke. OBJECTIVE: To characterize daily AF burden at first detection and the rate of temporal transition to higher device-detected AF burden. METHODS: A pooled analysis of data from 3 prospective projects was analyzed, and 6580 patients (mean age 68 ± 12 years, 72% male) with no history of AF and no use of anticoagulants at baseline were identified. Various thresholds of daily AF burden (5 minutes and 1, 6, 12, and 23 hours) were analyzed. RESULTS: Among the study population of 6580 patients, a new AF, with an AF burden of ≥5 minutes, was detected in 2244 patients (34%) during a follow-up period of 2.4 ± 1.7 years. Among these patients, 1091 (49.8%) transitioned to a higher AF-burden threshold during follow-up. A higher duration of daily AF burden manifest at first detection and CHADS2 score ≥2 were associated with faster transition to a subsequent higher burden. Approximately 24% of patients transitioned from a lower threshold to a daily AF burden of ≥23 hours during follow-up. CONCLUSION: More than one-third of patients with no history of AF developed device-detected AF, with attainment of different thresholds of daily AF burden over time. Continuous long-term monitoring, especially when the initial detection corresponds to a higher daily AF burden and the CHADS2 score is ≥2, could support timely clinical decisions on anticoagulation by capturing transitions to higher AF-burden thresholds.
Authors: Jacopo Francesco Imberti; Alberto Tosetti; Davide Antonio Mei; Anna Maisano; Giuseppe Boriani Journal: Curr Cardiol Rep Date: 2021-05-07 Impact factor: 2.931
Authors: Giuseppe Boriani; Marco Vitolo; Igor Diemberger; Marco Proietti; Anna Chiara Valenti; Vincenzo Livio Malavasi; Gregory Y H Lip Journal: Cardiovasc Res Date: 2021-06-16 Impact factor: 13.081
Authors: Vincenzo Russo; Antonio Rapacciuolo; Anna Rago; Vincenzo Tavoletta; Stefano De Vivo; Giuseppe Ammirati; Valerio Pergola; Giovanni Domenico Ciriello; Paola Napoli; Gerardo Nigro; Antonio D'Onofrio Journal: J Arrhythm Date: 2022-02-13
Authors: Venkatesh Ravi; Dominik Beer; Grzegorz M Pietrasik; Jillian L Hanifin; Sara Ooms; Muhammad Talha Ayub; Timothy Larsen; Henry D Huang; Kousik Krishnan; Richard G Trohman; Pugazhendhi Vijayaraman; Parikshit S Sharma Journal: J Am Heart Assoc Date: 2020-11-11 Impact factor: 5.501