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High incidence of subclinical atrial fibrillation in patients with syncope monitored with implantable cardiac monitor.

Abstract：

OBJECTIVE:The use of implantable cardiac monitors (ICM) is highly useful in syncope workup. Latest-generation devices can detect asymptomatic episodes of atrial fibrillation. The main objective of this study was to determine the incidence of subclinical atrial fibrillation (AF) detected in a patient population undergoing prolonged electrocardiographic monitoring with an ICM for the etiological workup of syncope. METHODS:Prospective observational study carried out in a tertiary hospital from April 2014 to October 2019. All consecutive adult patients monitored with a latest-generation ICM for syncope with no prior history of AF were included in the analysis. RESULTS:Of a total of 509 ICMs implanted during the study period, 208 patients fulfilled the inclusion criteria. 42 patients (20.2%) were found to have AF on ICM. The incidence of AF was 11.7 cases per 100 person-years (95% CI: 8.7-15.9 per 100 person-years). The median burden of AF was 0.2% (IQR 0-0.8%). Age, the presence of hypertension, chronic kidney disease, the size of the septum and left atrium on electrocardiogram and the presence of broad QRS on baseline electrocardiogram were predictors for the appearance of AF in the univariate analysis. CONCLUSION:The incidental finding of atrial fibrillation in patients with syncope monitored with ICM is common. The burden of AF is low, and it is generally subclinical. These findings create added value for the use of ICM in the workup for syncope, although further studies are needed to determine the clinical benefit of documenting subclinical AF.

journal_name

Int J Cardiol

journal_title

International journal of cardiology

authors

Francisco-Pascual J,Olivella San Emeterio A,Rivas-Gándara N,Pérez-Rodón J,Benito B,Santos-Ortega A,Moya-Mitjans À,Rodríguez García J,Llerena Butrón SI,Cantalapiedra Romero J,Ferreira González I

doi

10.1016/j.ijcard.2020.05.078

subject

Has Abstract

pub_date

2020-10-01 00:00:00

pages

110-116

eissn

0167-5273

issn

1874-1754

pii

S0167-5273(20)32451-7

journal_volume

316

pub_type

杂志文章

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