Key result
AT-Patch detects new-onset AF in ~24% of patients with prior HF and CHA2DS2-VASc ≥4.
Why the study?
Conventional ECG monitoring devices have drawbacks including short monitoring duration and invasive implantation, prompting evaluation of patch-type devices for detecting new-onset AF in high-risk patients.
Does an 11-day wearable continuous ECG monitoring device (AT-Patch) detect new-onset atrial fibrillation in adults with a CHA₂DS₂-VASc score ≥2?
Cohort (n=320)
Yes
Does an 11-day wearable continuous ECG monitoring device (AT-Patch) detect new-onset atrial fibrillation in adults with a CHA₂DS₂-VASc score ≥2?
An 11-day continuous ECG patch detected new-onset atrial fibrillation in 3.4% of high-risk patients, with the highest diagnostic yield in those with prior heart failure and a CHA₂DS₂-VASc score ≥4.
Supports targeted wearable monitoring in high-risk HF subgroups; hypothesis-generating and requires RCTs before practice change.
BACKGROUND While conventional electrocardiogram monitoring devices are useful for detecting atrial fibrillation, they have considerable drawbacks, including a short monitoring duration and invasive device implantation. The use of patch-type devices circumvents these drawbacks and has shown comparable diagnostic capability for the early detection of atrial fibrillation. OBJECTIVE We aimed to determine whether a patch-type device (AT-Patch) applied to patients with a high risk of new-onset atrial fibrillation defined by the congestive heart failure, hypertension, age ≥75 years, diabetes mellitus, stroke, vascular disease, age 65-74 years, sex scale (CHA₂DS₂-VASc) score had increased detection rates. METHODS In this nonrandomized multicenter prospective cohort study, we enrolled 320 adults aged ≥19 years who had never experienced atrial fibrillation and whose CHA₂DS₂-VASc score was ≥2. The AT-Patch was attached to each individual for 11 days, and the data were analyzed for arrhythmic events by 2 independent cardiologists. RESULTS Atrial fibrillation was detected by the AT-Patch in 3.4% (11/320) of patients, as diagnosed by both cardiologists. Interestingly, when participants with or without atrial fibrillation were compared, a previous history of heart failure was significantly more common in the atrial fibrillation group (n=4/11, 36.4% vs n=16/309, 5.2%, respectively; P=.003). When a CHA₂DS₂-VASc score ≥4 was combined with previous heart failure, the detection rate was significantly increased to 24.4%. Comparison of the recorded electrocardiogram data revealed that supraventricular and ventricular ectopic rhythms were significantly more frequent in the new-onset atrial fibrillation group compared with nonatrial fibrillation group (3.4% vs 0.4%; P=.001 and 5.2% vs 1.2%; P<.001), respectively. CONCLUSIONS This study detected a moderate number of new-onset atrial fibrillations in high-risk patients using the AT-Patch device. Further studies will aim to investigate the value of early detection of atrial fibrillation, particularly in patients with heart failure as a means of reducing adverse clinical outcomes of atrial fibrillation. CLINICALTRIAL ClinicalTrials.gov NCT04857268; https://classic.clinicaltrials.gov/ct2/show/NCT04857268
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Kwun et al. (2023) conducted a cohort in High risk of new-onset atrial fibrillation (n=320). AT-Patch was evaluated on Detection of new-onset atrial fibrillation. The AT-Patch detected new-onset atrial fibrillation in 3.4% of high-risk patients over 11 days, increasing to 24.4% in those with a CHA2DS2-VASc score ≥4 and previous heart failure.
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