The SilenT AtRial FIBrillation (STAR-FIB) study programme – design and rationale

Nozica, Nikolas; Lam, Anna; Goulouti, Eleni; Elchinova, Elena; Spirito, Alessandro; Branca, Mattia; Servatius, Helge; Noti, Fabian; Seiler, Jens; Baldinger, Samuel H.; Haeberlin, Andreas; Marchi, Stefano F. de; Asatryan, Babken; Rodondi, Nicolas; Donzé, Jacques; Aujesky, Drahomir; Tanner, Hildegard; Reichlin, Tobias; Jüni, Peter; Roten, Laurent

doi:10.4414/smw.2021.20421

Cited by 3 publications

(3 citation statements)

References 34 publications

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“…Left ventricular hypertrophy was defined as a left ventricular myocardial mass index above normal range according to the published criteria (≥102 g/m 2 in males and ≥88 g/m 2 in females) [ 19 ]. The STAR-FIB cohort study was an atrial fibrillation screening study that included 795 patients without atrial fibrillation, aged 65–84 years [ 20 , 21 ].…”

Section: Methodsmentioning

confidence: 99%

Differences in Atrial Remodeling in Hypertrophic Cardiomyopathy Compared to Hypertensive Heart Disease and Athletes’ Hearts

Servatius

Raab

Asatryan

et al. 2022

JCM

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Background: Hypertrophic cardiomyopathy (HCM), hypertensive heart disease (HHD) and athletes’ heart share an increased prevalence of atrial fibrillation. Atrial cardiomyopathy in these patients may have different characteristics and help to distinguish these conditions. Methods: In this single-center study, we prospectively collected and analyzed electrocardiographic (12-lead ECG, signal-averaged ECG (SAECG), 24 h Holter ECG) and echocardiographic data in patients with HCM and HHD and in endurance athletes. Patients with atrial fibrillation were excluded. Results: We compared data of 27 patients with HCM (70% males, mean age 50 ± 14 years), 324 patients with HHD (52% males, mean age 75 ± 5.5 years), and 215 endurance athletes (72% males, mean age 42 ± 7.5 years). HCM patients had significantly longer filtered P-wave duration (153 ± 26 ms) and PR interval (191 ± 48 ms) compared to HHD patients (144 ± 16 ms, p = 0.012 and 178 ± 31, p = 0.034, respectively) and athletes (134 ± 14 ms, p = 0.001 and 165 ± 26 ms, both p < 0.001, respectively). HCM patients had a mean of 4.9 ± 16 premature atrial complexes per hour. Premature atrial complexes per hour were significantly more frequent in HHD patients (27 ± 86, p < 0.001), but not in athletes (2.7 ± 23, p = 0.639). Left atrial volume index (LAVI) was 43 ± 14 mL/m2 in HCM patients and significantly larger than age- and sex-corrected LAVI in HHD patients 30 ± 10 mL/m2; p < 0.001) and athletes (31 ± 9.5 mL/m2; p < 0.001). A borderline interventricular septum thickness ≥13 mm and ≤15 mm was found in 114 (35%) HHD patients, 12 (6%) athletes and 3 (11%) HCM patients. Conclusion: Structural and electrical atrial remodeling is more advanced in HCM patients compared to HHD patients and athletes.

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Section: Methodsmentioning

confidence: 99%

Differences in Atrial Remodeling in Hypertrophic Cardiomyopathy Compared to Hypertensive Heart Disease and Athletes’ Hearts

Servatius

Raab

Asatryan

et al. 2022

JCM

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“…The STAR-FIB cohort study is a hospital-based, prospective cohort study and part of the STAR-FIB study program. The details of the study program have been described elsewhere, including a detailed description of the recruitment process [11].…”

Section: Methodsmentioning

confidence: 99%

“…A more detailed description of the statistical analysis can be found elsewhere [11]. The design allowed for the estimation of the number of inpatients aged 65-84 years admitted during the study period from 19 January 2015 to 26 June 2019, which was the estimated source population of the prospective cohort study.…”

Section: Statistical Analysesmentioning

confidence: 99%

Age and Sex Specific Prevalence of Clinical and Screen-Detected Atrial Fibrillation in Hospitalized Patients

Roten

Goulouti

Lam

et al. 2021

JCM

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Background: The prevalence of atrial fibrillation (AF) is high in older patients. The present study aimed to estimate the age and sex specific prevalence of clinical and screen-detected atrial fibrillation (AF) in hospitalized patients. Methods: The STAR-FIB cohort study was a prospective cohort study recruiting participants from a large source population of hospitalized patients aged 65–84 years. The estimated size of the source population was 26,035 (95% CI 25,918–26,152), and 795 consenting patients without clinical AF were included in the cohort study after stratification by sex and age (49.2% females; mean age 74.7 years). Patients in the cohort study underwent three seven-day Holter ECGs in intervals of two months to screen for AF. Results: In the source population, the estimated prevalence of clinical AF was 22.2% (95% CI 18.4–26.1), 23.8% for males (95% CI 20.9–26.6) and 19.8% for females (95% CI 17.3–22.4; p for difference between sexes, 0.004). There was a linear trend for an increase in the prevalence of clinical AF with increasing age, overall and in both sexes. In the cohort study, AF was newly diagnosed in 38 patients, for an estimated prevalence of screen-detected AF of 4.9% overall (95% CI 3.3–6.6), 5.5% in males (95% CI 3.2–7.8) and 4.0% in females (95% CI 2.0–6.0; p for difference between sexes, 0.041). The estimated prevalence of screen-detected AF in the source population was 3.8% overall, 4.2% in males and 3.2% in females. Conclusion: In a large hospital-based patient population aged 65–84 years, the prevalence of clinical AF and of screen-detected AF was 22.2% and 3.8%, respectively, and significantly higher in males than females.

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Incidental Arrhythmias During Atrial Fibrillation Screening With Repeat 7‐Day Holter ECGs in a Hospital‐Based Patient Population

Goulouti,

Lam,

Nozica

et al. 2024

JAHA

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Background Screening for atrial fibrillation (AF) may reveal incidental arrhythmias of relevance. The aim of this study was to describe incidental arrhythmias detected during screening for AF in the STAR‐FIB (Predicting SilenT AtRial FIBrillation in Patients at High Thrombembolic Risk) cohort study. Methods and Results In the STAR‐FIB cohort study, we screened hospitalized patients for AF with 3 repeat 7‐day Holter ECGs. We analyzed all Holter ECGs for the presence of the following incidental arrhythmias: (1) sinus node dysfunction, defined as sinus pause of ≥3 seconds’ duration; (2) second‐degree (including Wenckebach) or higher‐degree atrioventricular block (AVB); (3) sustained supraventricular tachycardia of ≥30 seconds’ duration; and (4) sustained ventricular tachycardia of ≥30 seconds’ duration. We furthermore report treatment decisions because of incidental arrhythmias. A total of 2077 Holter ECGs were performed in 794 patients (mean age, 74.7 years; 49% women), resulting in a mean cumulative duration of analyzable ECG signal of 414±136 hours/patient. We found incidental arrhythmias in 94 patients (11.8%). Among these were sinus node dysfunction in 14 patients (1.8%), AVB in 41 (5.2%), supraventricular tachycardia in 42 (5.3%), and ventricular tachycardia in 2 (0.3%). Second‐degree AVB was found in 23 patients (2.9%), 2:1 AVB in 10 (1.3%), and complete AVB in 8 (1%). Subsequently, 8 patients underwent pacemaker implantation, 1 for sinus node dysfunction (post‐AF conversion pause of 9 seconds) and 7 for advanced AVB. One patient had an implantable cardioverter‐defibrillator implanted for syncopal ventricular tachycardia. Conclusions Incidental arrhythmias were frequently detected during screening for AF in the STAR‐FIB study and resulted in device therapy in 1.1% of our cohort patients.

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The SilenT AtRial FIBrillation (STAR-FIB) study programme – design and rationale

Cited by 3 publications

References 34 publications

Differences in Atrial Remodeling in Hypertrophic Cardiomyopathy Compared to Hypertensive Heart Disease and Athletes’ Hearts

Differences in Atrial Remodeling in Hypertrophic Cardiomyopathy Compared to Hypertensive Heart Disease and Athletes’ Hearts

Age and Sex Specific Prevalence of Clinical and Screen-Detected Atrial Fibrillation in Hospitalized Patients

Incidental Arrhythmias During Atrial Fibrillation Screening With Repeat 7‐Day Holter ECGs in a Hospital‐Based Patient Population

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