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High incidence of subclinical atrial fibrillation in patients with syncope monitored with implantable cardiac monitor
- Source :
- International Journal of Cardiology. 316:110-116
- Publication Year :
- 2020
- Publisher :
- Elsevier BV, 2020.
-
Abstract
- Objective The use of implantable cardiac monitors (ICM) is highly useful in syncope workup. Latest-generation devices can detect asymptomatic episodes of atrial fibrillation. The main objective of this study was to determine the incidence of subclinical atrial fibrillation (AF) detected in a patient population undergoing prolonged electrocardiographic monitoring with an ICM for the etiological workup of syncope. Methods Prospective observational study carried out in a tertiary hospital from April 2014 to October 2019. All consecutive adult patients monitored with a latest-generation ICM for syncope with no prior history of AF were included in the analysis. Results Of a total of 509 ICMs implanted during the study period, 208 patients fulfilled the inclusion criteria. 42 patients (20.2%) were found to have AF on ICM. The incidence of AF was 11.7 cases per 100 person-years (95% CI: 8.7–15.9 per 100 person-years). The median burden of AF was 0.2% (IQR 0–0.8%). Age, the presence of hypertension, chronic kidney disease, the size of the septum and left atrium on electrocardiogram and the presence of broad QRS on baseline electrocardiogram were predictors for the appearance of AF in the univariate analysis. Conclusion The incidental finding of atrial fibrillation in patients with syncope monitored with ICM is common. The burden of AF is low, and it is generally subclinical. These findings create added value for the use of ICM in the workup for syncope, although further studies are needed to determine the clinical benefit of documenting subclinical AF.
- Subjects :
- Adult
medicine.medical_specialty
030204 cardiovascular system & hematology
Asymptomatic
Syncope
Electrocardiography
03 medical and health sciences
QRS complex
0302 clinical medicine
Interquartile range
Internal medicine
Atrial Fibrillation
medicine
Humans
030212 general & internal medicine
Subclinical infection
Univariate analysis
business.industry
Incidence
Incidence (epidemiology)
Atrial fibrillation
medicine.disease
Stroke
Electrocardiography, Ambulatory
Cardiology
medicine.symptom
Cardiology and Cardiovascular Medicine
business
Kidney disease
Subjects
Details
- ISSN :
- 01675273
- Volume :
- 316
- Database :
- OpenAIRE
- Journal :
- International Journal of Cardiology
- Accession number :
- edsair.doi.dedup.....9b32c843645365316d9ef2a446319bef