Electrocardiographic markers of subclinical atrial fibrillation detected by implantable loop recorder: insights from the LOOP Study
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Electrocardiographic markers of subclinical atrial fibrillation detected by implantable loop recorder : insights from the LOOP Study. / Xing, Lucas Yixi; Diederichsen, Soren Zoga; Hojberg, Soren; Krieger, Derk W.; Graff, Claus; Olesen, Morten S.; Nielsen, Jonas Bille; Brandes, Axel; Kober, Lars; Haugan, Ketil Jorgen; Svendsen, Jesper Hastrup.
I: Europace, Bind 25, Nr. 5, euad014, 2023.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Electrocardiographic markers of subclinical atrial fibrillation detected by implantable loop recorder
T2 - insights from the LOOP Study
AU - Xing, Lucas Yixi
AU - Diederichsen, Soren Zoga
AU - Hojberg, Soren
AU - Krieger, Derk W.
AU - Graff, Claus
AU - Olesen, Morten S.
AU - Nielsen, Jonas Bille
AU - Brandes, Axel
AU - Kober, Lars
AU - Haugan, Ketil Jorgen
AU - Svendsen, Jesper Hastrup
PY - 2023
Y1 - 2023
N2 - Aims Insights into subclinical atrial fibrillation (AF) development are warranted to inform the strategies of screening and subsequent clinical management upon AF detection. Hence, this study sought to characterize the onset and progression of subclinical AF with respect to 12-lead electrocardiogram (ECG) parameters.Methods and results We included AF-naive individuals aged 70-90 years with additional stroke risk factors who underwent implantable loop recorder (ILR) monitoring in the LOOP Study. Using data from daily ILR recordings and the computerized analysis of baseline ECG, we studied empirically selected ECG parameters for AF detection (>= 6 min), cumulative AF burden, long-lasting AF (>= 24 h), and AF progression. Of 1370 individuals included, 419 (30.6%) developed AF during follow-up, with a mean cumulative AF burden of 1.5% [95% CI: 1.2-1.8]. Several P-wave-related and ventricular ECG parameters were associated with new-onset AF and with cumulative AF burden in AF patients. P-wave duration (PWD), P-wave terminal force in Lead V-1, and interatrial block (IAB) further demonstrated significant associations with long-lasting AF. Among AF patients, we observed an overall reduction in cumulative AF burden over time (IRR 0.70 [95% CI: 0.51-0.96]), whereas IAB was related to an increased risk of progression to AF >= 24 h (HR 1.86 [95% CI: 1.02-3.39]). Further spline analysis also revealed longer PWD to be associated with this progression in AF duration.Conclusion We identified several ECG parameters associated with new-onset subclinical AF detected by ILR. Especially PWD and IAB were robustly related to the onset and the burden of AF as well as progression over time.
AB - Aims Insights into subclinical atrial fibrillation (AF) development are warranted to inform the strategies of screening and subsequent clinical management upon AF detection. Hence, this study sought to characterize the onset and progression of subclinical AF with respect to 12-lead electrocardiogram (ECG) parameters.Methods and results We included AF-naive individuals aged 70-90 years with additional stroke risk factors who underwent implantable loop recorder (ILR) monitoring in the LOOP Study. Using data from daily ILR recordings and the computerized analysis of baseline ECG, we studied empirically selected ECG parameters for AF detection (>= 6 min), cumulative AF burden, long-lasting AF (>= 24 h), and AF progression. Of 1370 individuals included, 419 (30.6%) developed AF during follow-up, with a mean cumulative AF burden of 1.5% [95% CI: 1.2-1.8]. Several P-wave-related and ventricular ECG parameters were associated with new-onset AF and with cumulative AF burden in AF patients. P-wave duration (PWD), P-wave terminal force in Lead V-1, and interatrial block (IAB) further demonstrated significant associations with long-lasting AF. Among AF patients, we observed an overall reduction in cumulative AF burden over time (IRR 0.70 [95% CI: 0.51-0.96]), whereas IAB was related to an increased risk of progression to AF >= 24 h (HR 1.86 [95% CI: 1.02-3.39]). Further spline analysis also revealed longer PWD to be associated with this progression in AF duration.Conclusion We identified several ECG parameters associated with new-onset subclinical AF detected by ILR. Especially PWD and IAB were robustly related to the onset and the burden of AF as well as progression over time.
KW - Atrial fibrillation
KW - Electrocardiography
KW - P-wave
KW - Cardiac arrhythmias
KW - Stroke
KW - PR INTERVAL
KW - RISK
KW - DURATION
KW - INDIVIDUALS
KW - ASSOCIATION
U2 - 10.1093/europace/euad014
DO - 10.1093/europace/euad014
M3 - Journal article
C2 - 37068888
VL - 25
JO - Europace
JF - Europace
SN - 1099-5129
IS - 5
M1 - euad014
ER -
ID: 347289677