What is the clinical evidence from this study?

Study design: Cohort. Population: Atrial fibrillation (n=568). Intervention: Combining AF presence/duration with CHADS2 score. Primary outcome: Incidence of thromboembolic events (p=0.035).

What question did this study set out to answer?

To assess thromboembolic event incidence by combining CHADS2 scores with continuous atrial fibrillation (AF) duration and compare intermittent versus continuous monitoring strategies.

October 31, 2008Journal of Cardiovascular ElectrophysiologyOpen Access

Presence and Duration of Atrial Fibrillation Detected by Continuous Monitoring: Crucial Implications for the Risk of Thromboembolic Events

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Key result

Combining AF presence and duration with the CHADS2 score identified two subpopulations with markedly different risks of thromboembolic events (0.8% vs 5%, P=0.035).

Why the study?

Does continuous monitoring of AF presence and duration combined with CHADS2 score improve risk stratification for thromboembolic events in patients with pacemakers and a history of AF?

Population

568 patients with an implanted pacemaker and a history of atrial fibrillation (AF)

Comparison

Continuous monitoring via implanted pacemaker… vs Simulated intermittent monitoring strategies

Design

Cohort

Follow-up

1 year

Authors

GBGiovanni Luca BottoElectrophysiology LPLuigi PadelettiElectrophysiology MSMassimo SantiniUniversità Cattolica del Sacro Cuore

Discussion

Member takes

Implication

May refine thromboembolic risk stratification in pacemaker patients; leaves open prospective validation before practice change.

Key Points

To assess thromboembolic event incidence by combining CHADS2 scores with continuous atrial fibrillation (AF) duration and compare intermittent versus continuous monitoring strategies.
Analyzed continuous 1-year monitoring data from 568 patients with an implanted pacemaker and a history of AF.
Stratified patients by CHADS2 score (0, 1, 2, ≥3) and AF duration: AF-free (<5 min/day), AF-5 minutes (5 min to 24 hours), and AF-24 hours (>24 hours).
Simulated the diagnostic sensitivity of 24-hour, 1-week, and 30-day Holter monitoring for detecting AF episodes lasting >5 minutes.
Ischemic thromboembolic events occurred in 14 patients (2.5%) during 1-year follow-up, with AF-24 hours in 39.2%, AF-5 minutes in 31.5%, and AF-free in 29.2% of the cohort.
Combining AF duration with CHADS2 score distinguished two subpopulations with significantly different thromboembolic event rates (0.8% vs 5.0%, P = 0.035).
Mean detection sensitivity for AF episodes >5 minutes was 44.4% for 24-hour Holter, 50.4% for 1-week Holter, and 65.1% for 1-month Holter monitoring.

Study Design

Type

Cohort (n=568)

Structured PICO

Does continuous monitoring of AF presence and duration combined with CHADS2 score improve risk stratification for thromboembolic events in patients with pacemakers and a history of AF?

Population

568 patients with an implanted pacemaker and a history of atrial fibrillation (AF)

Intervention

Continuous monitoring via implanted pacemaker for 1 year to assess AF presence and duration

Comparator

Simulated intermittent monitoring strategies (24-hour Holter, 1-week Holter, and 30-day Holter)

Outcome

Incidence of ischemic thromboembolic events in relationship with CHADS2 score and AF presence/durationhard clinical

Main Result

Absolute Event Rate: 0.8% vs 5%

p-value: p=0.035

Combining continuous AF monitoring data (presence and duration) with the CHADS2 score significantly improves thromboembolic risk stratification in patients with pacemakers.

Cite This Study

Botto et al. (2008) conducted a cohort in Atrial fibrillation (n=568). Combining AF presence/duration with CHADS2 score was evaluated on Incidence of thromboembolic events (p=0.035). Combining AF presence and duration with the CHADS2 score identified two subpopulations with markedly different risks of thromboembolic events (0.8% vs 5%, P=0.035).

synapsesocial.com/papers/6a0ef7d525c30b2cc7f9fbe2 https://doi.org/10.1111/j.1540-8167.2008.01320.x

Topics

Atrial fibrillation Persistent AF management Anticoagulation in AF

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October 31, 2008Journal of Cardiovascular ElectrophysiologyOpen Access

Presence and Duration of Atrial Fibrillation Detected by Continuous Monitoring: Crucial Implications for the Risk of Thromboembolic Events

View Full Paper

Ask AI

Bookmark

Key result

Combining AF presence and duration with the CHADS2 score identified two subpopulations with markedly different risks of thromboembolic events (0.8% vs 5%, P=0.035).

Why the study?

Does continuous monitoring of AF presence and duration combined with CHADS2 score improve risk stratification for thromboembolic events in patients with pacemakers and a history of AF?

Population

568 patients with an implanted pacemaker and a history of atrial fibrillation (AF)

Comparison

Continuous monitoring via implanted pacemaker… vs Simulated intermittent monitoring strategies

Design

Cohort

Follow-up

1 year

Authors

GBGiovanni Luca BottoElectrophysiology LPLuigi PadelettiElectrophysiology MSMassimo SantiniUniversità Cattolica del Sacro Cuore

Discussion

Member takes

Implication

May refine thromboembolic risk stratification in pacemaker patients; leaves open prospective validation before practice change.

Key Points

To assess thromboembolic event incidence by combining CHADS2 scores with continuous atrial fibrillation (AF) duration and compare intermittent versus continuous monitoring strategies.
Analyzed continuous 1-year monitoring data from 568 patients with an implanted pacemaker and a history of AF.
Stratified patients by CHADS2 score (0, 1, 2, ≥3) and AF duration: AF-free (<5 min/day), AF-5 minutes (5 min to 24 hours), and AF-24 hours (>24 hours).
Simulated the diagnostic sensitivity of 24-hour, 1-week, and 30-day Holter monitoring for detecting AF episodes lasting >5 minutes.
Ischemic thromboembolic events occurred in 14 patients (2.5%) during 1-year follow-up, with AF-24 hours in 39.2%, AF-5 minutes in 31.5%, and AF-free in 29.2% of the cohort.
Combining AF duration with CHADS2 score distinguished two subpopulations with significantly different thromboembolic event rates (0.8% vs 5.0%, P = 0.035).
Mean detection sensitivity for AF episodes >5 minutes was 44.4% for 24-hour Holter, 50.4% for 1-week Holter, and 65.1% for 1-month Holter monitoring.

Study Design

Type

Cohort (n=568)

Structured PICO

Does continuous monitoring of AF presence and duration combined with CHADS2 score improve risk stratification for thromboembolic events in patients with pacemakers and a history of AF?

Population

568 patients with an implanted pacemaker and a history of atrial fibrillation (AF)

Intervention

Continuous monitoring via implanted pacemaker for 1 year to assess AF presence and duration

Comparator

Simulated intermittent monitoring strategies (24-hour Holter, 1-week Holter, and 30-day Holter)

Outcome

Incidence of ischemic thromboembolic events in relationship with CHADS2 score and AF presence/durationhard clinical

Main Result

Absolute Event Rate: 0.8% vs 5%

p-value: p=0.035

Combining continuous AF monitoring data (presence and duration) with the CHADS2 score significantly improves thromboembolic risk stratification in patients with pacemakers.

Cite This Study

synapsesocial.com/papers/6a0ef7d525c30b2cc7f9fbe2 https://doi.org/10.1111/j.1540-8167.2008.01320.x

Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

Topics

Atrial fibrillation Persistent AF management Anticoagulation in AF

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