Mihail G Chelu1, Bruce D Gunderson2, Jodi Koehler2, Paul D Ziegler2, Samuel F Sears3. 1. Cardiovascular Medicine Division, Section of Cardiac Electrophysiology, University of Utah School of Medicine, Salt Lake City, Utah, USA. Electronic address: mgchelu@gmail.com. 2. Medtronic, Inc., Minneapolis, Minnesota, USA. 3. Department of Cardiovascular Sciences, Section of Cardiology, Brody School of Medicine at East Carolina University, Greenville, North Carolina, USA.
Abstract
OBJECTIVES: The study sought to determine the effect of persistent atrial fibrillation (AF) on device-measured activity and mortality. BACKGROUND: Patients with AF often complain of fatigue, which may be reflected in patient activity. Daily activity can be objectively measured by implanted devices. METHODS: We retrospectively studied patients (n = 266, 88% male, 69 ± 10 years of age) from the deidentified Medtronic CareLink database with persistent AF (≥28 consecutive days with ≥23 h of AF/day), dual-chamber implantable cardioverter-defibrillators (ICDs) capable of monitoring daily activity and AF burden, no AF between months 1 and 6 post-implant, and ≥1 year of data. RESULTS: The first persistent AF episode occurred 980 ± 534 days after implant and lasted a median of 87 days (interquartile range: 49 to 161 days). Average daily activity over a week just prior (baseline) to the first persistent AF episode was compared to each of the 4 weeks during the AF episode and to each of the weeks following termination of the persistent AF episode. Daily activity decreased significantly from the baseline week (135 min/day) compared to each of the 4 consecutive weeks after AF onset (8%, 11%, 14%, and 17% decrease, p < 0.001). Mortality at 4 years was increased in patients with persistent AF compared to a matched group with no persistent AF (20.6% vs. 8.6%, p < 0.01). CONCLUSIONS: Patients with ICDs have a significant reduction in activity following the onset of persistent AF and a significant increase in mortality when compared to a matched group without persistent AF. Objective measures of activity may more accurately reflect the impact of persistent AF on patients' functional status.
OBJECTIVES: The study sought to determine the effect of persistent atrial fibrillation (AF) on device-measured activity and mortality. BACKGROUND:Patients with AF often complain of fatigue, which may be reflected in patient activity. Daily activity can be objectively measured by implanted devices. METHODS: We retrospectively studied patients (n = 266, 88% male, 69 ± 10 years of age) from the deidentified Medtronic CareLink database with persistent AF (≥28 consecutive days with ≥23 h of AF/day), dual-chamber implantable cardioverter-defibrillators (ICDs) capable of monitoring daily activity and AF burden, no AF between months 1 and 6 post-implant, and ≥1 year of data. RESULTS: The first persistent AF episode occurred 980 ± 534 days after implant and lasted a median of 87 days (interquartile range: 49 to 161 days). Average daily activity over a week just prior (baseline) to the first persistent AF episode was compared to each of the 4 weeks during the AF episode and to each of the weeks following termination of the persistent AF episode. Daily activity decreased significantly from the baseline week (135 min/day) compared to each of the 4 consecutive weeks after AF onset (8%, 11%, 14%, and 17% decrease, p < 0.001). Mortality at 4 years was increased in patients with persistent AF compared to a matched group with no persistent AF (20.6% vs. 8.6%, p < 0.01). CONCLUSIONS:Patients with ICDs have a significant reduction in activity following the onset of persistent AF and a significant increase in mortality when compared to a matched group without persistent AF. Objective measures of activity may more accurately reflect the impact of persistent AF on patients' functional status.
Authors: Victoria L Bartlett; Joseph S Ross; Nilay D Shah; Laura Ciaccio; Joseph G Akar; Peter A Noseworthy; Sanket S Dhruva Journal: Cardiovasc Digit Health J Date: 2021-07-03
Authors: Maarten Z H Kolk; Diana M Frodi; Tariq O Andersen; Joss Langford; Soeren Z Diederichsen; Jesper H Svendsen; Hanno L Tan; Reinoud E Knops; Fleur V Y Tjong Journal: Cardiovasc Digit Health J Date: 2021-11-24
Authors: Tommy K Y Ng; Chris K C Kwok; Gabriel Y K Ngan; Horace K H Wong; Fadi Al Zoubi; Christy C Tomkins-Lane; Suk Ki Yau; Dino Samartzis; Sabina M Pinto; Siu-Ngor Fu; Heng Li; Arnold Y L Wong Journal: Arch Phys Med Rehabil Date: 2022-04-10 Impact factor: 4.060