Asymptomatic Atrial Fibrillation

Rho, Robert W.; Page, Richard L.

doi:10.1016/j.pcad.2005.06.005

Cited by 109 publications

(71 citation statements)

References 36 publications

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“…42 Fifth, obtaining an accurate time interval between the first PAF episode and the current examination was practically difficult because PAF is, by nature, an elusive disease, and the majority of PAF episodes are known to be asymptomatic. 43 Similarly, the first PAF episode in asymptomatic patients was noticed incidentally as an irregularly irregular rhythm during auscultation or palpitating arterial pulse and was confirmed using ECG at a monthly or biweekly consultation day; thus, the interval may be not accurate. Little information on the number and duration of PAF episodes was available in the present study.…”

Section: Study Limitationsmentioning

confidence: 99%

Left Atrial Volume Combined With Atrial Pump Function Identifies Hypertensive Patients With a History of Paroxysmal Atrial Fibrillation

et al. 2010

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Abstract-Identifying patients at high risk for the occurrence of atrial fibrillation is one means by which subsequent thromboembolic complications may be prevented. Left atrial enlargement is associated with progression of atrial remodeling, which is a substrate for atrial fibrillation, but impaired atrial pump function is also another aspect of the remodeling. Our objective was to differentiate patients with a history of paroxysmal atrial fibrillation using echocardiography. We studied 280 hypertensive patients (age: 66Ϯ7 years; left ventricular ejection fraction: 65Ϯ8%), including 140 consecutive patients with paroxysmal atrial fibrillation and 140 age-and sex-matched control subjects. Left atrial volume was measured using the modified Simpson method at both left ventricular end systole and preatrial contraction and was indexed to body surface area. Peak late-diastolic mitral annular velocity was measured during atrial contraction using pulsed tissue Doppler imaging as an atrial pump function. Left atrial volume index measured at left ventricular end systole had a 74% diagnostic accuracy and a 71% positive predictive value for identifying patients with paroxysmal atrial fibrillation; these values for the ratio of left atrial volume index at left ventricular end systole to the peak late-diastolic mitral annular velocity were 82% and 81%, respectively, and those for the ratio of left atrial volume index at preatrial contraction to the peak late-diastolic mitral annular velocity were 86% and 90%, respectively. In conclusion, left atrial size combined with atrial pump function enabled a more accurate diagnosis of a history of paroxysmal atrial fibrillation than conventional parameters. (Hypertension. 2010;55:1150-1156.)Key Words: hypertension Ⅲ echocardiography Ⅲ atrial fibrillation Ⅲ left atrium Ⅲ remodeling A trial fibrillation (AF) is not generally life threatening but is considered to be the most common cause of ischemic stroke, which often yields serious complications because of acute occlusion of intracranial arteries without collateral circulation. The incidence of stroke is increased by Ϸ5-fold in the presence of nonvalvular AF. [1][2][3][4][5] Moreover, recent studies have demonstrated that stroke risk is no less in patients with paroxysmal AF (PAF) than in those with persistent AF. 6 Therefore, it is crucial to identify patients who have PAF in order to prevent subsequent thromboembolic complications, especially in patients with hypertension, which is a major etiologic factor associated with both AF and stroke. [7][8][9] Left atrial (LA) enlargement associated with the progression of atrial structural remodeling plays a key role in the initiation and maintenance of AF. 10,11 The most recent recommendations for echocardiographic chamber quantification indicate that LA volume (LAV) provides an accurate measurement of asymmetrical remodeling of the LA chamber. 12 LAV is increased in patients with PAF 13 and is also an important predictor of cardiovascular outcome, including the occurrence of AF, 14 supporti...

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Section: Study Limitationsmentioning

confidence: 99%

Left Atrial Volume Combined With Atrial Pump Function Identifies Hypertensive Patients With a History of Paroxysmal Atrial Fibrillation

et al. 2010

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“…This term has also been previously used by few authors [12][13][14][15]. Other authors have used it as equivalent to prevalence of newly diagnosed AF [38] detected in some screening studies, or as the term undetected AF [42,46], and as unrecognized AF [47]. In our study represented a 2.2% of previously undiagnosed or the 20.2% of overall AF.…”

Section: Discussionmentioning

confidence: 68%

Diagnosed, undiagnosed and overall atrial fibrillation research on population over 60 year-old. AFABE study

Clúa-Espuny¹,

Princep²,

Roso-Llorach³

et al. 2014

Cardio Vasc Syst

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Background: Undiagnosed atrial fibrillation usually is only detected with the first complication. We estimated undiagnosed Atrial Fibrillation prevalence, overall AF and associated factors in a public health-service area in Catalonia, north-eastern Spain. Methods: Multicentre, cross-sectional study, with people randomly selected among the attended population over 60 years old by primary care teams regardless of follow-up time in health centres or at homes. Information was collected through ECGs, electronic medical history reviews and medical interviews. Descriptive and logistic regression analysis was performed. Results: 1043 subjects were recruited (47.1% male), mean age: 73.1 y-o (SD: 7.8 y-o); 43.3% ≥75-year-old. Overall AF prevalence was 10.9% (CI95% 9.1-12.8%); higher in men than in women, progressively increasing with age (24.4% in ≥85-year-old). Only women ≥85-year-old had higher prevalence (26.2%) than men (22.5%). Undiagnosed AF relative prevalence was 2.2% (IC95% 1.3-3.1%). These results show that about 1 in 50 people over 60 years old could suffer undiagnosed AF. The higher risk of AF undiagnosed was found in: men (OR 2.5 IC95% 1.0-6.2), >75 years old (OR 2.5 IC95% 1.0-6.1), heart failure history , who live in rural areas (OR 15.9 IC95% 1.5-160.1) and to whom no one ECG was performed in the last two years. Conclusions: The overall AF prevalence increased 10 times from the sixties to over eighties and the proportion man-woman changes from 4:1 to 1:1. The undiagnosed AF prevalence was 2.2% (IC95% 1.3-3.1). This percentage should be added to the one of untreated cases with OAC.

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“…It has been reported that even patients with symptomatic paroxysmal AF are unaware of more than half of the episodes of tachycardia recorded during ambulatory 24-h ECG. 35 In a study using the portable ECG monitoring device, Cardio-Phone, 30-70% of the episodes noticed as palpitation by patients with symptomatic AF were associated with sinus tachycardia or atrial extrasystole. 36 There are a number of methodological limitations hindering physicians ability to know when AF actually recurs, and none of the currently available monitoring methods, other than device systems, can make a correct evaluation.…”

Section: Study Limitationsmentioning

confidence: 99%

Relationship Between CHADS<sub>2</sub> Score and Efficacy of Antiarrhythmic Drug Therapy in Patients With Paroxysmal Atrial Fibrillation

Kubo

Satō

Ozawa

et al. 2013

Circ J

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Background:The Cardiac failure, Hypertension, Age, Diabetes, Stroke [Doubled] (CHADS2) score is a useful scheme for risk stratification of thromboembolism patients, but there is little information about its usefulness for the evaluation of antiarrhythmic drug (AAD) therapy. Methods and Results:This study included 459 paroxysmal atrial fibrillation (AF) patients (309 men, mean age 66±12 years, mean follow-up 50±35 months) and prophylactic efficacy was analyzed on the basis of CHADS2 score.(1) Survival rates free from AF recurrence at 1, 6, 12 and 24 months were, respectively, 89%, 74%, 63% and 47% in score-0 group (n=152); 92%, 68%, 59% and 48% in score-1 group (n=158); 86%, 64%, 56% and 46% in score-2 group (n=84); 81%, 65%, 51% and 35% in score-3 group (n=43); and 68%, 50%, 36% and 18% in ≥score-4 group (n=22) (P<0.05; score-0, score-1 or score-2 vs. ≥score-4 group). (2) Survival rates free from progression to chronic AF at 12, 36, 60 and 90 months were, respectively, 95%, 93%, 91% and 89% in score-0 group; 97%, 91%, 89% and 88% in score-1 group; 96%, 93%, 88% and 83% in score-2 group; 91%, 74%, 67% and 60% in score-3 group; and 91%, 82%, 68% and 55% in ≥score-4 group (P<0.01; score-0, score-1 or score-2 vs. ≥score-4 group). (3) In multivariate logistic regression analysis adjusted for potentially confounding variables, CHADS2 score was associated with AF recurrence (odds ratio [OR] 1.45, 95% confidence interval [CI] 1.16-1.81, P<0.001), and progression to chronic AF during AAD therapy (OR 1.64, 95% CI 1.04-2.69, P<0.001).Conclusions: When using a rhythm control strategy, the CHADS2 score is a useful scheme for predicting the outcome of AAD treatment of patients with paroxysmal AF. (Circ J 2013; 77: 639 -645)

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Asymptomatic Atrial Fibrillation

Cited by 109 publications

References 36 publications

Left Atrial Volume Combined With Atrial Pump Function Identifies Hypertensive Patients With a History of Paroxysmal Atrial Fibrillation

Left Atrial Volume Combined With Atrial Pump Function Identifies Hypertensive Patients With a History of Paroxysmal Atrial Fibrillation

Diagnosed, undiagnosed and overall atrial fibrillation research on population over 60 year-old. AFABE study

Relationship Between CHADS<sub>2</sub> Score and Efficacy of Antiarrhythmic Drug Therapy in Patients With Paroxysmal Atrial Fibrillation

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