Abstract
Covert atrial fibrillation (AF) accounts for cryptogenic stroke aetiology in elderly patients and in younger populations. However, asymptomatic AF is difficult to diagnose based on a short electrocardiography (ECG) recording. We evaluated the feasibility of a self-applied continuous ECG monitoring device that can record automatically, easily, and noninvasively in a younger population. We investigated community screening for asymptomatic AF using a wireless single-lead ECG with an electrode embedded in a T-shirt. One hundred men with a CHADS2 score ≥1 who were free from AF and <65 years of age were enrolled. We instructed the participants to wear ECG monitoring devices for at least 4 days/week over 2 months. The proportion of participants with newly detected AF (NDAF) and the monitoring time were evaluated. The mean CHADS2 score was 1.43 ± 0.62. The mean patient age was 52.5 ± 5.4 years. The mean monitoring time was 222 ± 199 hours. NDAF continuing for >30 seconds was detected in 10 participants (10.0%). AF continuing for >6 minutes was detected in 2 participants (2.0%). The T-shirt-type wearable ECG monitoring system was suitable for continuous, daily long-term use among young people with high physical activity, and it had the distinct capability of identifying covert AF.
Highlights
Effective than conventional follow-up for detecting atrial fibrillation (AF) in patients with cryptogenic stroke[5]
The detection of covert AF is as necessary for first stroke prevention in young adults as it is in elderly people
We investigated the incidence of newly detected AF (NDAF) lasting 6 minutes in groups of patients with an intermediate (CHADS2 score of 1), high (CHADS2 score of 2), and very high stroke risk (CHADS2 score of ≥3)
Summary
Effective than conventional follow-up for detecting AF in patients with cryptogenic stroke[5]. Wearable continuous ECG monitoring patches and iPhone-based lead-I ECG (iECG) were found to be superior to conventional follow-up for detecting AF in randomised controlled trials[10,11,12]. These studies have been conducted in only elderly patient populations. The detection of covert AF is as necessary for first stroke prevention in young adults as it is in elderly people. We evaluated the feasibility of a noninvasive, wearable ECG monitoring with an electrode embedded in a T-shirt that is suitable for young people’s lifestyle and sports activities
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