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Detection of unknown atrial fibrillation by prolonged ECG monitoring in an all-comer patient cohort and association with clinical and Holter variables

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Detection of unknown atrial fibrillation by prolonged ECG monitoring in an all-comer patient cohort and association with clinical and Holter variables. / Jawad-Ul-Qamar, Muhammad; Chua, Winnie; Purmah, Yanish; Nawaz, Mohammad; Varma, Chetan; Davis, Russell; Maher, Abdul; Fabritz, Larissa; Kirchhof, Paulus.

In: OPEN HEART, Vol. 7, No. 1, e001151, 04.05.2020.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Jawad-Ul-Qamar, M, Chua, W, Purmah, Y, Nawaz, M, Varma, C, Davis, R, Maher, A, Fabritz, L & Kirchhof, P 2020, 'Detection of unknown atrial fibrillation by prolonged ECG monitoring in an all-comer patient cohort and association with clinical and Holter variables', OPEN HEART, vol. 7, no. 1, e001151. https://doi.org/10.1136/openhrt-2019-001151

APA

Jawad-Ul-Qamar, M., Chua, W., Purmah, Y., Nawaz, M., Varma, C., Davis, R., Maher, A., Fabritz, L., & Kirchhof, P. (2020). Detection of unknown atrial fibrillation by prolonged ECG monitoring in an all-comer patient cohort and association with clinical and Holter variables. OPEN HEART, 7(1), [e001151]. https://doi.org/10.1136/openhrt-2019-001151

Vancouver

Jawad-Ul-Qamar M, Chua W, Purmah Y, Nawaz M, Varma C, Davis R et al. Detection of unknown atrial fibrillation by prolonged ECG monitoring in an all-comer patient cohort and association with clinical and Holter variables. OPEN HEART. 2020 May 4;7(1). e001151. https://doi.org/10.1136/openhrt-2019-001151

Bibtex

@article{56e7d0bc8cc54100a93dbb57dd68d0b4,
title = "Detection of unknown atrial fibrillation by prolonged ECG monitoring in an all-comer patient cohort and association with clinical and Holter variables",
abstract = "OBJECTIVES: Prolonged ECG monitoring is clinically useful to detect unknown atrial fibrillation (AF) in stroke survivors. The diagnostic yield of prolonged ECG monitoring in other patient populations is less well characterised. We therefore studied the diagnostic yield of prolonged Holter ECG monitoring for AF in an unselected patient cohort referred from primary care or seen in a teaching hospital.METHODS: We analysed consecutive 7-day ECG recordings in unselected patients referred from different medical specialities and assessed AF detection rates by indication, age and comorbidities.RESULTS: Seven-day Holter ECGs (median monitoring 127.5 hours, IQR 116 to 152) were recorded in 476 patients (mean age 54.6 (SD 17.0) years, 55.9% female) without previously known AF, requested to evaluate palpitations (n=241), syncope (n=99), stroke or transient ischaemic attack (n=75), dizziness (n=29) or episodic chest pain (n=32). AF was newly detected in 42/476 (8.8%) patients. Oral anticoagulation was initiated in 40/42 (95.2%) patients with newly detected AF. Multivariate logistic regression, adjusted for age, sex and monitoring duration found four clinical parameters to be associated with newly detected AF: hypertension OR=2.54, (1.08 to 8.61) (adjusted OR (95% CI)), p=0.034; previous stroke or TIA OR=4.14 (1.81 to 13.01), p=0.001; left-sided valvular heart disease OR=5.07 (2.48 to 18.70), p<0.001 and palpitations OR=2.86, (1.33 to 10.44), p=0.015.CONCLUSIONS: Open multispeciality access to prolonged ECG monitoring, for example, as part of integrated, cross-sector AF care, can accelerate diagnosis of AF and increase adequate use of oral anticoagulation, especially in older and symptomatic patients with comorbidities.",
keywords = "Action Potentials, Administration, Oral, Adult, Age Factors, Aged, Aged, 80 and over, Anticoagulants/administration & dosage, Atrial Fibrillation/diagnosis, Comorbidity, Electrocardiography, Ambulatory, Female, Heart Disease Risk Factors, Heart Rate, Humans, Male, Middle Aged, Predictive Value of Tests, Prognosis, Risk Assessment, Time Factors",
author = "Muhammad Jawad-Ul-Qamar and Winnie Chua and Yanish Purmah and Mohammad Nawaz and Chetan Varma and Russell Davis and Abdul Maher and Larissa Fabritz and Paulus Kirchhof",
note = "{\textcopyright} Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY. Published by BMJ.",
year = "2020",
month = may,
day = "4",
doi = "10.1136/openhrt-2019-001151",
language = "English",
volume = "7",
journal = "OPEN HEART",
issn = "2053-3624",
publisher = "BMJ PUBLISHING GROUP",
number = "1",

}

RIS

TY - JOUR

T1 - Detection of unknown atrial fibrillation by prolonged ECG monitoring in an all-comer patient cohort and association with clinical and Holter variables

AU - Jawad-Ul-Qamar, Muhammad

AU - Chua, Winnie

AU - Purmah, Yanish

AU - Nawaz, Mohammad

AU - Varma, Chetan

AU - Davis, Russell

AU - Maher, Abdul

AU - Fabritz, Larissa

AU - Kirchhof, Paulus

N1 - © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY. Published by BMJ.

PY - 2020/5/4

Y1 - 2020/5/4

N2 - OBJECTIVES: Prolonged ECG monitoring is clinically useful to detect unknown atrial fibrillation (AF) in stroke survivors. The diagnostic yield of prolonged ECG monitoring in other patient populations is less well characterised. We therefore studied the diagnostic yield of prolonged Holter ECG monitoring for AF in an unselected patient cohort referred from primary care or seen in a teaching hospital.METHODS: We analysed consecutive 7-day ECG recordings in unselected patients referred from different medical specialities and assessed AF detection rates by indication, age and comorbidities.RESULTS: Seven-day Holter ECGs (median monitoring 127.5 hours, IQR 116 to 152) were recorded in 476 patients (mean age 54.6 (SD 17.0) years, 55.9% female) without previously known AF, requested to evaluate palpitations (n=241), syncope (n=99), stroke or transient ischaemic attack (n=75), dizziness (n=29) or episodic chest pain (n=32). AF was newly detected in 42/476 (8.8%) patients. Oral anticoagulation was initiated in 40/42 (95.2%) patients with newly detected AF. Multivariate logistic regression, adjusted for age, sex and monitoring duration found four clinical parameters to be associated with newly detected AF: hypertension OR=2.54, (1.08 to 8.61) (adjusted OR (95% CI)), p=0.034; previous stroke or TIA OR=4.14 (1.81 to 13.01), p=0.001; left-sided valvular heart disease OR=5.07 (2.48 to 18.70), p<0.001 and palpitations OR=2.86, (1.33 to 10.44), p=0.015.CONCLUSIONS: Open multispeciality access to prolonged ECG monitoring, for example, as part of integrated, cross-sector AF care, can accelerate diagnosis of AF and increase adequate use of oral anticoagulation, especially in older and symptomatic patients with comorbidities.

AB - OBJECTIVES: Prolonged ECG monitoring is clinically useful to detect unknown atrial fibrillation (AF) in stroke survivors. The diagnostic yield of prolonged ECG monitoring in other patient populations is less well characterised. We therefore studied the diagnostic yield of prolonged Holter ECG monitoring for AF in an unselected patient cohort referred from primary care or seen in a teaching hospital.METHODS: We analysed consecutive 7-day ECG recordings in unselected patients referred from different medical specialities and assessed AF detection rates by indication, age and comorbidities.RESULTS: Seven-day Holter ECGs (median monitoring 127.5 hours, IQR 116 to 152) were recorded in 476 patients (mean age 54.6 (SD 17.0) years, 55.9% female) without previously known AF, requested to evaluate palpitations (n=241), syncope (n=99), stroke or transient ischaemic attack (n=75), dizziness (n=29) or episodic chest pain (n=32). AF was newly detected in 42/476 (8.8%) patients. Oral anticoagulation was initiated in 40/42 (95.2%) patients with newly detected AF. Multivariate logistic regression, adjusted for age, sex and monitoring duration found four clinical parameters to be associated with newly detected AF: hypertension OR=2.54, (1.08 to 8.61) (adjusted OR (95% CI)), p=0.034; previous stroke or TIA OR=4.14 (1.81 to 13.01), p=0.001; left-sided valvular heart disease OR=5.07 (2.48 to 18.70), p<0.001 and palpitations OR=2.86, (1.33 to 10.44), p=0.015.CONCLUSIONS: Open multispeciality access to prolonged ECG monitoring, for example, as part of integrated, cross-sector AF care, can accelerate diagnosis of AF and increase adequate use of oral anticoagulation, especially in older and symptomatic patients with comorbidities.

KW - Action Potentials

KW - Administration, Oral

KW - Adult

KW - Age Factors

KW - Aged

KW - Aged, 80 and over

KW - Anticoagulants/administration & dosage

KW - Atrial Fibrillation/diagnosis

KW - Comorbidity

KW - Electrocardiography, Ambulatory

KW - Female

KW - Heart Disease Risk Factors

KW - Heart Rate

KW - Humans

KW - Male

KW - Middle Aged

KW - Predictive Value of Tests

KW - Prognosis

KW - Risk Assessment

KW - Time Factors

U2 - 10.1136/openhrt-2019-001151

DO - 10.1136/openhrt-2019-001151

M3 - SCORING: Journal article

C2 - 32371464

VL - 7

JO - OPEN HEART

JF - OPEN HEART

SN - 2053-3624

IS - 1

M1 - e001151

ER -