The HAT2CH2 score predicts neurologic events in patients with cardiac implantable electronic devices without atrial fibrillation

2022 ◽  
Author(s):  
Ju-Yi Chen ◽  
Tse-Wei Chen ◽  
Wei-Da Lu
Keyword(s):  
Atrial Fibrillation ◽  
Electronic Devices ◽  
Cardiac Implantable Electronic Devices

scholarly journals Subclinical Atrial Fibrillation and Risk of Stroke: Past, Present and Future

Medicina ◽  
2019 ◽  
Vol 55 (10) ◽  
pp. 611 ◽  
Author(s):  
AlTurki ◽  
Marafi ◽  
Russo ◽  
Proietti ◽  
Essebag
Keyword(s):  
Atrial Fibrillation ◽  
Clinical Practice ◽  
Electronic Devices ◽  
High Rate ◽  
Cardiac Monitoring ◽  
Stroke Event ◽  
Cardiac Implantable Electronic Devices ◽  
Increased Risk ◽  
History Of ◽  
New Evidence

Subclinical atrial fibrillation (SCAF) describes asymptomatic episodes of atrial fibrillation (AF) that are detected by cardiac implantable electronic devices (CIED). The increased utilization of CIEDs renders our understanding of SCAF important to clinical practice. Furthermore, 20% of AF present initially as a stroke event and prolonged cardiac monitoring of stroke patients is likely to uncover a significant prevalence of SCAF. New evidence has shown that implanting cardiac monitors into patients with no history of atrial fibrillation but with risk factors for stroke will yield an incidence of SCAF approaching 30–40% at around three years. Atrial high rate episodes lasting longer than five minutes are likely to represent SCAF. SCAF has been associated with an increased risk of stroke that is particularly significant when episodes of SCAF are greater than 23 hours in duration. Longer episodes of SCAF are incrementally more likely to progress to episodes of SCAF >23 hours as time progresses. While only around 30–40% of SCAF events are temporally related to stroke events, the presence of SCAF likely represents an important risk marker for stroke. Ongoing trials of anticoagulation in patients with SCAF durations less than 24 hours will inform clinical practice and are highly anticipated. Further studies are needed to clarify the association between SCAF and clinical outcomes as well as the factors that modify this association.

scholarly journals Subclinical and Device-Detected Atrial Fibrillation: Pondering the Knowledge Gap: A Scientific Statement From the American Heart Association

Circulation ◽  
2019 ◽  
Vol 140 (25) ◽  
Author(s):  
Peter A. Noseworthy ◽  
Elizabeth S. Kaufman ◽  
Lin Y. Chen ◽  
Mina K. Chung ◽  
Mitchell S.V. Elkind ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Stroke Risk ◽  
American Heart ◽  
Electronic Devices ◽  
Heart Association ◽  
Cardiac Implantable Electronic Devices ◽  
Increased Risk ◽  
Scientific Statement ◽  
Existing Data

The widespread use of cardiac implantable electronic devices and wearable monitors has led to the detection of subclinical atrial fibrillation in a substantial proportion of patients. There is evidence that these asymptomatic arrhythmias are associated with increased risk of stroke. Thus, detection of subclinical atrial fibrillation may offer an opportunity to reduce stroke risk by initiating anticoagulation. However, it is unknown whether long-term anticoagulation is warranted and in what populations. This scientific statement explores the existing data on the prevalence, clinical significance, and management of subclinical atrial fibrillation and identifies current gaps in knowledge and areas of controversy and consensus.

Clinical significance of atrial fibrillation detected by cardiac implantable electronic devices

Heart Rhythm ◽  
2014 ◽  
Vol 11 (4) ◽  
pp. 719-724 ◽  
Author(s):  
Anthony E. DeCicco ◽  
Jonathan B. Finkel ◽  
Arnold J. Greenspon ◽  
Daniel R. Frisch
Keyword(s):  
Atrial Fibrillation ◽  
Clinical Significance ◽  
Electronic Devices ◽  
Cardiac Implantable Electronic Devices

scholarly journals 444 Epidemiology of subclinical atrial fibrillation in patients with cardiac implantable electronic devices: a systematic review and meta-regression

2021 ◽  
Vol 23 (Supplement_G) ◽  
Author(s):  
Marco Borgi ◽  
Marco Proietti ◽  
Giulio Francesco Romiti ◽  
Marco Vitolo ◽  
Arianna Di Rocco ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Systematic Review ◽  
Regression Analysis ◽  
Electronic Devices ◽  
Older Age ◽  
Cardiac Implantable Electronic Devices ◽  
History Of ◽  
Meta Regression ◽  
Meta Regression Analysis

Abstract Aims In recent years, attention to subclinical atrial fibrillation (SCAF), defined as the presence of atrial high-rate episodes (AHREs), in patients with cardiac implantable electronic devices (CIEDs), has gained much interest as a determinant of clinical AF and stroke risk. To perform a systematic review and meta-regression of the available scientific evidence regarding the epidemiology of SCAF in patients receiving CIEDs. Methods and results PubMed and EMBASE were searched for all studies documenting the incidence of AHREs in patients (n = 100 or more) with CIEDs without any previous history of AF from inception to 20 August 2021, screened by two independent blind reviewers. This study was registered in PROSPERO: CRD42019106994. Among the 2614 results initially retrieved, 54 studies were included, with a total of 72 784 patients. Meta-analysis of included studies showed a pooled prevalence of SCAF of 28.1%, with an incidence rate (IR) of 16 new SCAF cases per 100 patient-years (I2 = 100%). Multivariate meta-regression analysis showed that age and follow-up time were the only significant determinants of IR, explaining a large part of the heterogeneity (R2 = 61.5%, P < 0.001), with higher IR at earlier follow-up and in older patients, decreasing over follow-up time and increasing according to mean age. Older age, higher CHA2DS2-VASc score, history of AF, hypertension, CHF, and stroke/TIA were all associated with SCAF occurrence. Conclusions In this systematic review and meta-regression analysis, IR of SCAF increased with age and decreased over longer follow-up times. SCAF was associated with older age, higher thromboembolic risk, and several cardiovascular comorbidities.

Cardiac implantable electronic device remote monitoring in a large cohort of patients and the need for planning

2020 ◽  
Vol 16 (5) ◽  
pp. 447-456
Author(s):  
Franco Zoppo ◽  
Antonio Lupo ◽  
Giacomo Mugnai ◽  
Francesca Zerbo
Keyword(s):  
Atrial Fibrillation ◽  
Remote Monitoring ◽  
Electronic Device ◽  
Descriptive Analysis ◽  
Electronic Devices ◽  
Standard Of Care ◽  
Large Cohort ◽  
Cardiac Implantable Electronic Device ◽  
Cardiac Implantable Electronic Devices

Aim: The remote monitoring (RM) of cardiac implantable electronic devices (CIED) is standard of care. We describe an organizational and projection RM workload model. Methods: At the time of the analysis (2015), 3995 CIED patients were followed-up; 1582 (40.5%) with RM. All RM transmissions (Tx) have been gathered in five event types. Results: We received 10,406 Tx, classified as: 128 (1.2%) red alerts, 141 (1.3%) atrial fibrillation episodes, 1944 (18.6%) yellow alerts, 403 (3.9%) lost Tx (disconnected/noncompliant patients) and 7790 (75.0%) Tx ‘OK' (un-eventful Tx). At the time of 100% of remote CIED managed, we can expect a total of 25,990 Tx/year. Conclusion: We provide a descriptive analysis of remote monitoring management and workload estimation in a large cohort of CIED patients.

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