Abstract
Introduction: Subclinical atrial fibrillation (AF) has been associated with greater stroke risk; however, subclinical AF can be intermittent, and hence hard to detect. Little is known about the diagnostic yield of extending electrocardiogram (ECG) monitoring beyond 2 weeks on subclinical AF detection, particularly among individuals without a clinical indication. Hypothesis: Extending ECG monitoring from 2 weeks to 4 weeks will increase detection of AF Methods: We included ARIC study participants who attended visit 6 (2016-2017), without a history of AF, and who wore a leadless, ambulatory ECG monitor (Zio® XT Patch by iRhythm Technologies Inc.) twice, each time for up to a maximum of 2 weeks. AF history was based on ARIC ascertainment (hospitalization codes through 2016, ECGs at prior ARIC visits 1-5) or self-reported AF at visit 6. AF on the Zio® XT Patch was defined as an irregularly irregular rhythm with absent P-waves lasting ≥30 seconds. Results: We included 387 ARIC participants (mean ± SD aged 79 ± 4 years, 54% female, 11% non-white race). Mean recording time was 13.3 ± 1.7 days for the first Ziopatch, 13.1 ± 2.0 for the second patch, and 26.4 ± 2.9 for the combined 4 weeks. Based on ≤2 weeks of monitoring, the prevalence of subclinical AF was 2.6% (95% CI: 1.0-4.2%; n=10); this increased to 4.4% (95% CI: 2.4-6.4%; n=17) with ≤4 weeks of monitoring. Thus, the incremental diagnostic yield of 4 weeks versus 2 weeks of monitoring was 70% (95% CI: 41.6-98.4%). The mean time to first AF episode was 10.5 ± 8.0 days with a median of 13.4 days (IQR=2.0-19.7). Cumulative yield of AF detection over the monitoring time is shown in the Figure . Conclusions: Among elderly community-dwelling individuals, extending ECG monitoring from 2 weeks to 4 weeks increased detection of AF. These findings help inform the debate on ECG screening for subclinical AF; however, more research is needed to define the optimal duration of ECG monitoring time.
Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
