Atrial fibrillation detection using a novel three-vector cardiac implantable monitor: the atrial fibrillation detect study

Ciconte, Giuseppe; Saviano, Massimo; Giannelli, Luigi; Ćalović, Žarko; Baldi, Mario; Ciaccio, Cristiano; Cuko, Amarild; Vitale, Raffaele; Giacopelli, Daniele; Conti, Manuel; Lipartiti, Felicia; Giordano, Federica; Maresca, Fabio; Moscatiello, Mario; Vicedomini, Gabriele; Santinelli, Vincenzo; Pappone, Carlo

doi:10.1093/europace/euw181

Cited by 33 publications

(30 citation statements)

References 18 publications

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“…Several approved ILR devices are available (fig 7 and fig 8). 82 In general, most automated algorithms use variability in the R-R interval to detect atrial fibrillation 838485. Some newer devices’ algorithms also incorporate the presence/absence of a P wave 86Table 7.…”

Section: Newer Detection Methodsmentioning

confidence: 99%

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Newer technologies for detection of atrial fibrillation

Zungsontiporn

Link

2018

BMJ

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Atrial fibrillation is a common arrhythmia that is associated with increased risk of stroke, which can be reduced with appropriate anticoagulation treatment. However, it remains underdiagnosed in contemporary clinical practice using conventional detection methods, resulting in missed opportunities to implement appropriate treatment. Newer technologies developed in recent years can potentially enhance the detection of atrial fibrillation and overcome certain limitations of the conventional methods. However, uncertainties remain about their use and the significance of atrial fibrillation detected by some of these newer technologies. This review examines the evidence supporting the use of some of these technologies and evaluates their applications in certain clinical scenarios.

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Section: Newer Detection Methodsmentioning

confidence: 99%

“…Some newer devices’ algorithms also incorporate the presence/absence of a P wave 86Table 7. summarizes studies evaluating the sensitivity and specificity of ILRs 83848587…”

Section: Newer Detection Methodsmentioning

confidence: 99%

Newer technologies for detection of atrial fibrillation

Zungsontiporn

Link

2018

BMJ

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“…In our study, 3 patients (10%) had no AF episode, whereas 9 patients (30%) did not experience any other symptomatic episode. These findings provide strong evidence that only continuous monitoring of the arrhythmia can exclude AF recurrences and identify AF‐free patients …”

Section: Discussionmentioning

confidence: 65%

“…These findings provide strong evidence that only continuous monitoring of the arrhythmia can exclude AF recurrences and identify AF-free patients. 7 The AF recurrence rate during the natural course of the arrhythmia should be viewed as very important, as it may have serious clinical implications that affect the management of the patient after the first appearance of the arrhythmia. Should the physician recommend antiarrhythmics and/or pulmonary vein ablation?…”

Section: Discussionmentioning

confidence: 99%

“…Nowadays, continuous long‐term rhythm monitoring and remote rhythm monitoring have been made feasible by the use of implantable loop recorders (ILRs). ILRs are small, subcutaneously implanted devices that are able to detect and store AF episodes lasting longer than 2 minutes with high sensitivity (96.1%–100%) and good specificity (67%–85.4%) . In this study, using such devices, we evaluated the recurrence profile of AF, including symptomatic and asymptomatic episodes, after the first ECG‐documented symptomatic episode, and we searched for clinical, demographic, and echocardiographic factors associated with the recurrence profile of the arrhythmia.…”

Section: Introductionmentioning

confidence: 99%

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Recurrence rate of atrial fibrillation after the first clinical episode: A prospective evaluation using continuous cardiac rhythm monitoring

Simantirakis

Papakonstantinou

Kanoupakis

et al. 2018

Clinical Cardiology

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Background Decision making regarding a patient who has experienced a first clinical episode of atrial fibrillation (AF) is challenging, and the AF recurrences should be a significant consideration. Continuous long‐term rhythm monitoring via implantable loop recorders (ILRs) has enabled us to evaluate the AF recurrence profile after the first clinical episode and to investigate clinical parameters associated with the course of the arrhythmia. Hypothesis Continuous rhythm monitoring via ILRs in AF patients after the first clinical episode is of clinical significance and precisely evaluate the AF recurrence profile. Methods Thirty consecutive patients with paroxysmal AF received an ILR after their first symptomatic episode. We evaluated the maximum duration of episodes and the recurrence rate of the arrhythmia during a follow‐up period of 3 years. Results Three patients (10%) had no AF recurrence, whereas 4 patients (13.3%) presented only 1 episode. Almost half of the patients (46.7%) had a low recurrence rate (<5 episodes/year), whereas the majority of patients (19/30) suffered from episodes with maximum duration ≤24 hours. Eleven patients (36.7%) presented either no episode or a low recurrence rate with episodes lasting ≤24 hours. The use of statins was greater in patients with a low recurrence rate (P = 0.025). Conclusions A significant percentage of patients either suffer no AF recurrence after their first symptomatic episode or show a low recurrence rate. Most patients present episodes of short duration. If these findings are confirmed in larger studies, they could have clinical implications ensuring individualized management of the arrhythmia in the future.

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Implantable loop recorder in clinical practice

Bisignani

Bonis

Mancuso

et al. 2018

Journal of Arrhythmia

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The implantable loop recorder (ILR), also known as insertable cardiac monitor (ICM) is a subcutaneous device used for diagnosing heart rhythm disorders. These devices have been strongly improved and miniaturized during the last years showing several reliable features along with the availability of remote monitoring which improves the diagnostic timing and the follow‐up strategy with a potential reduction of costs for health care. The recent advent of injectable ILRs makes the procedure even easier and more tolerated by patients. ILR allows the investigation of unexplained recurrent syncope with uncertain diagnosis, revealing a possible relationship with cardiac arrhythmias. In addition, it has recently been equipped with sophisticated algorithms able to detect atrial fibrillation episodes. This new opportunity may provide to the physicians systematic heart rhythm screening with possible effects on patient antiarrhythmic and anticoagulant therapy management. The use of such devices will surely increase, since they may be helpful to diagnose a wide range of disorders and pathologies. Indeed, further studies should be performed in order to identify all the potentialities of these tools.

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Atrial fibrillation detection using a novel three-vector cardiac implantable monitor: the atrial fibrillation detect study

Cited by 33 publications

References 18 publications

Newer technologies for detection of atrial fibrillation

Newer technologies for detection of atrial fibrillation

Recurrence rate of atrial fibrillation after the first clinical episode: A prospective evaluation using continuous cardiac rhythm monitoring

Implantable loop recorder in clinical practice

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