Long-term risk of recurrent atrial fibrillation as documented by an implantable monitoring device

Israel, Carsten W.; Grönefeld, Gerian; Ehrlich, Joachim R.; Li, Yi‐Gang; Hohnloser, Stefan H.

doi:10.1016/j.jacc.2003.08.027

Cited by 429 publications

(81 citation statements)

References 29 publications

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“…1 Studies with transtelephonic arrhythmia monitoring or implantable monitoring devices have reported asymptomatic AF in up to 50% of patients evaluated. 1,2 The patient cohorts observed in most of these studies participated in population surveys such as the Framingham Study, in antiarrhythmic drug trials, or in instances where monitoring followed pacemaker implantation for sinus node dysfunction or atrioventricular block. 1,2 The incidence of asymptomatic arrhythmia in patients presenting with highly symptomatic AF who qualified for radiofrequency (RF) catheter ablation is unknown.…”

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confidence: 99%

“…1,2 The patient cohorts observed in most of these studies participated in population surveys such as the Framingham Study, in antiarrhythmic drug trials, or in instances where monitoring followed pacemaker implantation for sinus node dysfunction or atrioventricular block. 1,2 The incidence of asymptomatic arrhythmia in patients presenting with highly symptomatic AF who qualified for radiofrequency (RF) catheter ablation is unknown. Because AF catheter ablation is a new and potentially curative therapy and is currently performed in an increasing number of patients, data on asymptomatic AF in this subset of patients may have important implications for the overall success rate as well as for the individual patient with regard to concomitant medical therapy, eg, oral anticoagulation.…”

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Perception of Atrial Fibrillation Before and After Radiofrequency Catheter Ablation

et al. 2005

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Background-The objective of this study was to assess the incidence and impact of asymptomatic arrhythmia in patients with highly symptomatic atrial fibrillation (AF) who qualified for radiofrequency (RF) catheter ablation. Methods and Results-In this prospective study, 114 patients with at least 3 documented AF episodes together with corresponding symptoms and an ineffective trial of at least 1 antiarrhythmic drug were selected for RF ablation. With the use of CARTO, circumferential lesions around the pulmonary veins and linear lesions at the roof of the left atrium and along the left atrial isthmus were placed. A continuous, 7-day, Holter session was recorded before ablation, right after ablation, and after 3, 6, and 12 months of follow-up. During each 7-day Holter monitoring, the patients recorded quality and duration of any complaints by using a detailed symptom log. More than 70 000 hours of ECG recording were analyzed. In the 7-day Holter records before ablation, 92 of 114 patients (81%) had documented AF episodes. All episodes were symptomatic in 35 patients (38%). In 52 patients (57%), both symptomatic and asymptomatic episodes were recorded, whereas in 5 patients (5%), all documented AF episodes were asymptomatic. After ablation, the percentage of patients with only asymptomatic AF recurrences increased to 37% (PϽ0.05) at the 6-month follow-up. An analysis of patient characteristics and arrhythmia patterns failed to identify a specific subset who were at high risk for the development of asymptomatic AF. Conclusions-Even

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Perception of Atrial Fibrillation Before and After Radiofrequency Catheter Ablation

et al. 2005

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“…In a study of patients with artificial pacemakers, Israel et al [21] demonstrated a high incidence of AF recurrence >48 h duration in asymptomatic patients. The complications and risks of such silent episodes of AF are believed to be similar to those associated with symptoms [22].…”

Section: Diagnosis Of Afmentioning

confidence: 99%

Prevention of Stroke in Patients with Atrial Fibrillation: The Role of New Antiarrhythmic and Antithrombotic Drugs

Röther

Crijns

2010

Cerebrovasc Dis

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Background: Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia. It is associated with increased cardiovascular mortality and morbidity, including stroke. Results: Rate or rhythm control and prevention of thromboembolism with oral anticoagulants are the main management objectives for patients with AF. Until recently, rhythm control studies did not show prevention of cardiovascular complications. However, dronedarone, a novel antiarrhythmic drug, has been shown to decrease stroke risk by 34% (p = 0.027). In addition, the Randomized Evaluation of Long-Term Anticoagulant Therapy trial showed significant stroke reductions with the anticoagulant dabigatran 150 mg b.i.d. compared with adjusted-dose warfarin (the results for dabigatran 110 mg b.i.d. were similar to warfarin). Conclusions: Novel antithrombotic agents and antiarrhythmic agents with cardiovascular prophylactic properties may enhance the management of stroke risk in patients with AF.

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“…Paroxysmal AF (PAF), also termed intermittent AF, is defined as an episode of AF that terminates spontaneously or with intervention in less than seven days [3]. The frequency of PAF is uncertain, because previous studies have suggested that a majority of these episodes are asymptomatic [4,5], including some that may last more than 48 h [4]. Experienced clinicians can identify AF patterns by visual inspection of the electrocardiogram (ECG) chart.…”

Section: Introductionmentioning

confidence: 99%

Automated Detection of Paroxysmal Atrial Fibrillation Using an Information-Based Similarity Approach

Cui

Chang

Yang

et al. 2017

Entropy

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Atrial fibrillation (AF) is an abnormal rhythm of the heart, which can increase heart-related complications. Paroxysmal AF episodes occur intermittently with varying duration. Human-based diagnosis of paroxysmal AF with a longer-term electrocardiogram recording is time-consuming. Here we present a fully automated ensemble model for AF episode detection based on RR-interval time series, applying a novel approach of information-based similarity analysis and ensemble scheme. By mapping RR-interval time series to binary symbolic sequences and comparing the rank-frequency patterns of m-bit words, the dissimilarity between AF and normal sinus rhythms (NSR) were quantified. To achieve high detection specificity and sensitivity, and low variance, a weighted variation of bagging with multiple AF and NSR templates was applied. By performing dissimilarity comparisons between unknown RR-interval time series and multiple templates, paroxysmal AF episodes were detected. Based on our results, optimal AF detection parameters are symbolic word length m = 9 and observation window n = 150, achieving 97.04% sensitivity, 97.96% specificity, and 97.78% overall accuracy. Sensitivity, specificity, and overall accuracy vary little despite changes in m and n parameters. This study provides quantitative information to enhance the categorization of AF and normal cardiac rhythms.

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Long-term risk of recurrent atrial fibrillation as documented by an implantable monitoring device

Cited by 429 publications

References 29 publications

Perception of Atrial Fibrillation Before and After Radiofrequency Catheter Ablation

Perception of Atrial Fibrillation Before and After Radiofrequency Catheter Ablation

Prevention of Stroke in Patients with Atrial Fibrillation: The Role of New Antiarrhythmic and Antithrombotic Drugs

Automated Detection of Paroxysmal Atrial Fibrillation Using an Information-Based Similarity Approach

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