Detection of atrial fibrillation using an implantable loop recorder in patients with previous cryptogenic stroke: the SPIDER-AF registry (Stroke Prevention by Increasing DEtection Rates of Atrial Fibrillation)

Rybak, Karin; D´Ancona, Giuseppe; Glück, Simon; Haerer, Winfried; Goss, Franz; ,

doi:10.1007/s00392-023-02283-4

Cited by 1 publication

(1 citation statement)

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“…Moreover, the tools available to assess AF episodes and burden, including 24-h Holter monitoring and 12-lead ECG, may lead to underestimation of AF recurrence compared with implanted or continuous rhythm monitoring devices. 22,43 The 4S-AF scheme is a dynamic score, but we only assessed it at baseline and had limited follow-up data for periodic reassessment. Furthermore, there is some overlap between the four domains.…”

Section: Study Limitationsmentioning

confidence: 99%

Clinical utility of the 4S-AF scheme in predicting recurrence of atrial fibrillation after radiofrequency catheter ablation

Cui,

Li,

Sun

et al. 2024

Preprint

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Background: The 4S-AF scheme, consisting of four domains related to atrial fibrillation (AF) [stroke risk (St), symptoms (Sy), severity of AF burden (Sb), and substrate (Su)], represents a novel approach for the structural characterization of AF. We aimed to assess the clinical utility of the scheme in predicting AF recurrence after radiofrequency catheter ablation (RFCA). Methods: We prospectively enrolled 345 consecutive patients with AF who underwent initial RFCA between January 2019 and December 2019. The 4S-AF scheme score was calculated and used to characterize AF. The primary outcome assessed was AF recurrence after RFCA, defined as any documented atrial tachyarrhythmia episode lasting at least 30 seconds. Results: Of 345 patients [age 61 (IQR: 53-68) years, 34.2% female, 70.7% paroxysmal AF] were analyzed. The median duration of AF history was 12 (IQR: 3-36) months, and the median number of comorbidities was 2 (IQR: 1-3), and 157 (45.5%) patients had left atrial enlargement. During a median follow-up period of 28 (IQR: 13-37) months, AF recurrence occurred in 34.4% of patients. Both 4S-AF scheme score (HR 1.38, 95% CI: 1.19?1.59, P<0.001) and 2S-AF scheme by eliminating the Sy and St domains (HR 1.59, 95% CI: 1.33?1.89, P<0.001) were independent predictors of AF recurrence after RFCA. For each domain, we found that the independent predictors were Sb (HR 1.84, 95% CI: 1.25?2.72, P=0.002) and Su (HR 1.71, 95% CI: 1.36?2.14, P<0.001). Furthermore, 4S-AF scheme score (AUC 65.2%, 95% CI: 59.3?71.1) and 2S-AF scheme score (AUC 66.2%, 95% CI: 60.2?72.1) had a modest ability to predict AF recurrence after RFCA. Conclusions: The novel 4S-AF scheme is feasible for evaluating and characterizing AF patients who undergo RFCA and aids us in identifying patients with a high risk of AF recurrence after RFCA.

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Section: Study Limitationsmentioning

confidence: 99%