Atrial fibrillation detected by continuous electrocardiographic monitoring using implantable loop recorder to prevent stroke in individuals at risk (the LOOP study): Rationale and design of a large randomized controlled trial

Diederichsen, Søren Zöga; Haugan, Ketil; Køber, Lars; Højberg, Søren; Brandes, Axel; Kronborg, Christian; Graff, Claus; Holst, Anders G.; Nielsen, Jonas B.; Krieger, Derk; Svendsen, Jesper Hastrup

doi:10.1016/j.ahj.2017.02.017

Cited by 60 publications

(56 citation statements)

References 51 publications

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“…We suggest reporting data for the entire follow-up period and following patients for at least 1 year, preferably longer. Insertable Cardiac Monitor devices may be preferred in the future as they are becoming smaller and less expensive, and these devices can detect AF/Arrhythmia on a continuous basis for a longer period depending on the battery capacity [ 15 ]. However, there is risk of ‘noise’ and hence over-estimation of AF/arrhythmia.…”

Section: Discussionmentioning

confidence: 99%

Percutaneous versus thoracoscopic ablation of symptomatic paroxysmal atrial fibrillation: a randomised controlled trial - the FAST II study

Sindby

Vadmann

Lundbye‐Christensen

et al. 2018

J Cardiothorac Surg

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BackgroundThe most efficient first-time invasive treatment, for achieving sinus rhythm, in symptomatic paroxysmal atrial fibrillation has not been established. We aimed to compare percutaneous catheter and video-assisted thoracoscopic pulmonary vein radiofrequency ablation in patients referred for first-time invasive treatment due to symptomatic paroxysmal atrial fibrillation. The primary outcome of interest was the prevalence of atrial fibrillation with and without anti-arrhythmic drugs at 12 months.MethodsNinety patients were planned to be randomised to either video-assisted thoracoscopic radiofrequency pulmonary vein ablation with concomitant left atrial appendage excision or percutaneous catheter pulmonary vein ablation. Episodes of atrial fibrillation were defined as more than 30 s of atrial fibrillation observed on Holter monitoring/telemetry or clinical episodes documented by ECG.ResultsThe study was terminated prematurely due to a lack of eligible patients. Only 21 patients were randomised and treated according to the study protocol. Thoracoscopic pulmonary vein ablation was performed in 10 patients, and 11 patients were treated with catheter ablation. The absence of atrial fibrillation without the use of anti-arrhythmic drugs throughout the follow-up was observed in 70% of patients following thoracoscopic pulmonary vein ablation and 18% after catheter ablation (p < 0.03).ConclusionThoracoscopic pulmonary vein ablation may be superior to catheter ablation for first-time invasive treatment of symptomatic paroxysmal atrial fibrillation with regard to obtaining sinus rhythm off anti-arrhythmic drugs 12 months postoperative.Trial registrationClinicalTrials.gov Identifier: NCT01336075. Registered April 15th, 2011.

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Section: Discussionmentioning

confidence: 99%

Percutaneous versus thoracoscopic ablation of symptomatic paroxysmal atrial fibrillation: a randomised controlled trial - the FAST II study

Sindby

Vadmann

Lundbye‐Christensen

et al. 2018

J Cardiothorac Surg

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“…A detailed description of the study design has been published previously. 11 In brief, participants from the general population residing in 3 of the 5 administrative regions of Denmark are identified by administrative registries and receive a letter of invitation from one of the four study centers. Eligible subjects are ≥70 years old and have ≥1 of the following stroke risk factors; hypertension, diabetes, heart failure or previous stroke.…”

Section: Methodsmentioning

confidence: 99%

“…The ongoing LOOP study randomizes individuals with CHA2DS2VASc score of ≥2 to AF screening with implantable loop recorder (ILR) screening or control. 11 The study's power calculation assumes that 30% of participants receiving ILR will have AF detected, and that stroke can be reduced by OAC in these patients. The primary endpoint will be published according to protocol, when the required number of events is reached.…”

Section: Introductionmentioning

confidence: 99%

Incidence and predictors of atrial fibrillation episodes as detected by implantable loop recorder in patients at risk: From the LOOP study

Diederichsen

Haugan

Brandes

et al. 2020

American Heart Journal

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“…International Journal of Arrhythmia *Correspondence: jykim0706@yuhs.ac 3 Division of Cardiology, Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, 146-92, Dogok-dong, Gangnam-gu, Seoul 06273, Korea Full list of author information is available at the end of the article a loop recorder is a valuable diagnostic aid for AF [5], invasiveness and high costs are limitations precluding its routine use.…”

Section: Open Accessmentioning

confidence: 99%

Multiple atrial premature contractions predict stroke recurrence in patients with cryptogenic stroke and concomitant non-sustained atrial tachycardia

et al. 2020

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Background and objectives: Atrial fibrillation is a known risk factor for cryptogenic stroke and therefore requires early detection and prompt management. We investigated predictors of stroke recurrence in patients with cryptogenic stroke and concomitant non-sustained atrial tachycardia but not atrial fibrillation. Subjects and methods: We investigated 390 patients (219 men, mean age 67 ± 12 years) diagnosed with stroke and non-sustained atrial tachycardia on 24-h Holter monitoring and recorded the total number of atrial premature contractions identified by the Holter monitor. Multiple atrial premature contractions were defined as atrial premature contractions > 34 beats/day. We analyzed the rates of 5-year freedom from stroke recurrence or atrial fibrillation and investigated independent predictors of stroke recurrence and undiagnosed atrial fibrillation. Results: The mean follow-up period was 35 ± 21 months, and the overall stroke recurrence rate was 9.0%. Kaplan-Meier survival analysis revealed that the rate of freedom from stroke recurrence was significantly lower in patients with multiple atrial premature contractions. Also, the patients with multiple atrial premature contractions had higher cumulative incidence rate of new-onset AF (p = 0.019). Multivariate analysis showed that multiple atrial premature contractions (hazard ratio 2.49, 95% confidence interval 1.05-5.88, p = 0.038), cigarette smoking status (hazard ratio 2.66, 95% confidence interval 1.15-6.17, p = 0.022), and the left atrial volume index (hazard ratio 1.05, 95% confidence interval 1.01-1.09, p = 0.020) were significantly associated with stroke recurrence in patients with cryptogenic stroke. However, these factors were not statistically significant predictors of future onset of atrial fibrillation. Conclusions: Multiple atrial premature contractions were significantly correlated with an increased left atrial volume index, which could predict future onset of atrial fibrillation and stroke recurrence. This study showed that multiple atrial premature contractions predict stroke recurrence in patients with cryptogenic stroke without atrial fibrillation.

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Atrial fibrillation detected by continuous electrocardiographic monitoring using implantable loop recorder to prevent stroke in individuals at risk (the LOOP study): Rationale and design of a large randomized controlled trial

Cited by 60 publications

References 51 publications

Percutaneous versus thoracoscopic ablation of symptomatic paroxysmal atrial fibrillation: a randomised controlled trial - the FAST II study

Percutaneous versus thoracoscopic ablation of symptomatic paroxysmal atrial fibrillation: a randomised controlled trial - the FAST II study

Incidence and predictors of atrial fibrillation episodes as detected by implantable loop recorder in patients at risk: From the LOOP study

Multiple atrial premature contractions predict stroke recurrence in patients with cryptogenic stroke and concomitant non-sustained atrial tachycardia

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