Device-detected atrial fibrillation and risk for stroke: an analysis of >10 000 patients from the SOS AF project (Stroke preventiOn Strategies based on Atrial Fibrillation information from implanted devices)
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Open Access
- 11 December 2013
- journal article
- research article
- Published by Oxford University Press (OUP) in European Heart Journal
- Vol. 35 (8), 508-516
- https://doi.org/10.1093/eurheartj/eht491
Abstract
The aim of this study was to assess the association between maximum daily atrial fibrillation (AF) burden and risk of ischaemic stroke. Cardiac implanted electronic devices (CIEDs) enhance detection of AF, providing a comprehensive measure of AF burden. A pooled analysis of individual patient data from five prospective studies was performed. Patients without permanent AF, previously implanted with CIEDs, were included if they had at least 3 months of follow-up. A total of 10 016 patients (median age 70 years) met these criteria. The risk of ischaemic stroke associated with pre-specified cut-off points of AF burden (5 min, 1, 6, 12, and 23 h, respectively) was assessed. During a median follow-up of 24 months, 43% of 10 016 patients experienced at least 1 day with at least 5 min of AF burden and for them the median time to the maximum AF burden was 6 months (inter-quartile range: 1.3–14). A Cox regression analysis adjusted for the CHADS2 score and anticoagulants at baseline demonstrated that AF burden was an independent predictor of ischaemic stroke. Among the thresholds of AF burden that we evaluated, 1 h was associated with the highest hazard ratio (HR) for ischaemic stroke, i.e. 2.11 (95% CI: 1.22–3.64, P = 0.008). Device-detected AF burden is associated with an increased risk of ischaemic stroke in a relatively unselected population of CIEDs patients. This finding may add to the basis for timely and clinically appropriate decision-making on anticoagulation treatment.Keywords
This publication has 22 references indexed in Scilit:
- Stroke and bleeding risk assessment in atrial fibrillation: when, how, and why?European Heart Journal, 2012
- Device-Detected Atrial Tachyarrhythmias Predict Adverse Outcome in Real-World Patients With Implantable Biventricular DefibrillatorsJournal of the American College of Cardiology, 2011
- Stroke Incidence Is Decreasing in Whites But Not in BlacksStroke, 2010
- Performance of a New Leadless Implantable Cardiac Monitor in Detecting and Quantifying Atrial Fibrillation Results of the XPECT TrialCirculation: Arrhythmia and Electrophysiology, 2010
- The Relationship Between Daily Atrial Tachyarrhythmia Burden From Implantable Device Diagnostics and Stroke RiskCirculation: Arrhythmia and Electrophysiology, 2009
- Presence and Duration of Atrial Fibrillation Detected by Continuous Monitoring: Crucial Implications for the Risk of Thromboembolic EventsJournal of Cardiovascular Electrophysiology, 2009
- Comparison of Risk Stratification Schemes to Predict Thromboembolism in People With Nonvalvular Atrial FibrillationJournal of the American College of Cardiology, 2008
- Monitored Atrial Fibrillation Duration Predicts Arterial Embolic Events in Patients Suffering From Bradycardia and Atrial Fibrillation Implanted With Antitachycardia PacemakersJournal of the American College of Cardiology, 2005
- Accuracy of Atrial Tachyarrhythmia Detection in Implantable Devices with Arrhythmia TherapiesPacing and Clinical Electrophysiology, 2004
- Validation of Clinical Classification Schemes for Predicting StrokeJAMA, 2001