Publication: Nonsustained atrial fibrillation in ambulatory ECG recording and thromboembolic events in long-term follow-up
Program
KU-Authors
KU Authors
Co-Authors
Karaüzüm, Kurtuluş
Karaüzüm, İrem Yilmaz
Çelikyurt, Yengi Umut
Hancı, Kaan
Aktaş, Müjdat
Sinan, Ümit Yaşar
Küçükoğlu, Mehmet Serdar
Fıratlı, İnci
Ağır, Ayşen Ağaçdiken
Advisor
Publication Date
2017
Language
English
Type
Meeting Abstract
Journal Title
Journal ISSN
Volume Title
Abstract
Background: Short-lasting (<30 s), nonsustained episodes of atrial fibrillation (NS-AF) are frequently observed in ambulatory ECG monitoring. Although they are considered as a risk factor for future persistent/permanent AF and stroke, real-life data on the indence of thromboembolic events in these patients are limited. This study aimed to examine whether NS-AF detected in Holter monitoing increases the risk of thromboembolic events. Methods: A total of 6,117 Holter monitorings were evaluated after excluding patients with paroxysmal/persistant/permenant atrial fibrillation, valvular heart diseases and known thrombembolic events. The control group consisted of 114 patients without any detected arrhythmia. Both groups were followed-up for a mean of 5.5 years, and new onset thromboembolic events were recorded. Results: NS-AF episodes were detected in 134 patients (2.2%). Twenty-one subjects (15.7%) in NS-AF group experienced stroke and 9 (6.7%) deceased during the follow-up period, whereas the corresponding numbers were 5 (4.4%) and 2 (1.8%) in controls respectively (p=0.004 and p=0.069). After adjusting for baseline risk factors, both NS-AF and CHADS-VASc were associated with stroke (HR: 3.58; 95% confidence interval [CI]: 1.26 to 10.16) and HR: 1.77; 95% CI: 1.34 to 2.24). In ROC analysis of the NS-AF group, a CHADs-VASc score ≥2 had a sensitivity of 91%, a specificity of 38%, a postive predictivity of 21% and a negative predictivity of 95% to predict stroke (AUC 0.74; 95% CI 0.63–0.85; p=0.001). Conclusions: NS-AF is associated with an increased risk of stroke, and especially in NS-AF patients with a CHADS-VASc ≥2 oral anticoagulation should be considered.
Description
Source:
European Heart Journal
Publisher:
Oxford University Press (OUP)
Keywords:
Subject
Heart, Arrhythmia, Cardiovascular systems