Simulated daily snapshot ECG monitoring over 365 days detected atrial tachycardia or atrial fibrillation in 49.6% of patients who had the arrhythmias detected by continuous implantable device monitoring.
Observational (n=370)
Yes
Does daily snapshot ECG monitoring effectively identify paroxysmal atrial fibrillation in continuously monitored patients with stroke risk factors?
Daily snapshot ECG monitoring over 365 days detects only half of patients who developed AT/AF as detected by continuous CIED monitoring, highlighting the limitations of intermittent monitoring strategies.
Absolute Event Rate: 49.6% vs 100%
BACKGROUND: New technologies are diffusing into medical practice swiftly. Hand-held devices such as smartphones can record short-duration (e.g., 1-minute) ECGs, but their effectiveness in identifying patients with paroxysmal atrial fibrillation (AF) is unknown. METHODS: We used data from the TRENDS study, which included 370 patients (mean age 71 years, 71% men, CHADS2 score≥1 point: mean 2.3 points) who had no documentation of atrial tachycardia (AT)/AF or antiarrhythmic or anticoagulant drug use at baseline. All were subsequently newly diagnosed with AT/AF by a cardiac implantable electronic device (CIED) over one year of follow-up. Using a computer simulation approach (5,000 repetitions), we estimated the detection rate for paroxysmal AT/AF via daily snapshot ECG monitoring over various periods, with the probability of detection equal to the percent AT/AF burden on each day. RESULTS: The estimated AT/AF detection rates with snapshot monitoring periods of 14, 28, 56, 112, and 365 days were 10%, 15%, 21%, 28%, and 50% respectively. The detection rate over 365 days of monitoring was higher in those with CHADS2 scores ≥2 than in those with CHADS2 scores of 1 (53% vs. 38%), and was higher in those with AT/AF burden ≥0.044 hours/day compared to those with AT/AF burden <0.044 hours/day (91% vs. 14%; both P<0.05). CONCLUSIONS: Daily snapshot ECG monitoring over 365 days detects half of patients who developed AT/AF as detected by CIED, and shorter intervals of monitoring detected fewer AT/AF patients. The detection rate was associated with individual CHADS2 score and AT/AF burden. TRIAL REGISTRATION: ClinicalTrials.gov NCT00279981.
Yano et al. (Tue,) conducted a observational in Stroke risk factors and newly diagnosed atrial fibrillation/tachycardia (n=370). Simulated daily snapshot ECG monitoring vs. Continuous cardiac implantable electronic device (CIED) monitoring was evaluated on Detection rate of atrial tachycardia/fibrillation over 365 days of monitoring (95% CI 43.3-55.9). Simulated daily snapshot ECG monitoring over 365 days detected atrial tachycardia or atrial fibrillation in 49.6% of patients who had the arrhythmias detected by continuous implantable device monitoring.