Key result
Long-term ECG monitoring detects silent AF in a median of ~6 days.
Why the study?
The optimal duration of ECG monitoring to increase the probability of diagnosing paroxysmal silent atrial fibrillation (SAF) was unknown.
Does up to 30 days of non-invasive long-term ECG monitoring improve the detection of silent atrial fibrillation in asymptomatic individuals?
Cross-Sectional (n=3,014)
Yes
Does up to 30 days of non-invasive long-term ECG monitoring improve the detection of silent atrial fibrillation in asymptomatic individuals?
A 14-day non-invasive ECG monitoring period is sufficient to detect the first episode of silent atrial fibrillation in at least 75% of at-risk patients.
Answers are grounded in this paper and cite their sources.
Supports 14-day noninvasive monitoring to capture most silent AF; hypothesis-generating and requires prospective RCTs before practice change.
INTRODUCTION: Although it is well‑known that longer electrocardiographic (ECG) monitoring allows for detection of paroxysmal silent atrial fibrillation (SAF), it is still unknown how long the ECG monitoring should last to increase the probability of SAF diagnosis. OBJECTIVES: Our aim was to analyze ECG acquisition parameters and timing to detect SAF during the Noninvasive Monitoring for Early Detection of Atrial Fibrillation study. PATIENTS AND METHODS: The protocol assumed up to 30 days of ECG telemonitoring of each participant in order to reveal AF / atrial flutter (AFL) episodes lasting at least 30 seconds. SAF was defined as AF detected and confirmed by cardiologists in asymptomatic individuals. The ECG signal analysis was based on the results of 2974 participants (98.67%). AF/AFL episodes were registered and confirmed by cardiologists in 515 individuals, that is, 75.7% of all patients (n = 680) in whom AF/AFL diagnosis was established. RESULTS: The median monitoring time to detect the first SAF episode was 6 days (interquartile range [IQR], 1-13). Fifty percent of the patients with this type of arrhythmia were identified by 6th day (IQR, 1-13) of the monitoring, and 75% by the 13th day of the study. Paroxysmal AF was registered on average on 4th day (IQR, 1-10). CONCLUSIONS: The ECG monitoring time to detect the first episode of SAF in at least 75% of patients at risk of this arrhythmia was 14 days. Detection of 1 patient with de novo AF, SAF, or de novo SAF, required monitoring of, respectively, 17, 11, and 23 patients.
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Mitręga et al. (2023) conducted a cross-sectional in Silent atrial fibrillation (n=3,014). Noninvasive long-term ECG monitoring (NOMED-AF TECH) was evaluated on Time to detect the first episode of silent atrial fibrillation. Noninvasive long-term ECG monitoring detected the first episode of silent atrial fibrillation with a median time of 6 days, identifying 75% of cases within 14 days.
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