Predicting Determinants of Atrial Fibrillation or Flutter for Therapy Elucidation in Patients at Risk for...

Area of Science:

• Cardiology
• Medical Devices
• Public Health

Background:

• Atrial fibrillation (AF) is a common cardiac arrhythmia and a major cause of stroke.
• Oral anticoagulants (OACs) significantly reduce stroke risk in AF patients.
• Optimal AF screening strategies and patient populations remain undetermined.

Purpose of the Study:

• To evaluate the CHA2DS2-VASc score for predicting new-onset AF using insertable cardiac monitors (ICMs).
• To determine if AF screening with ICMs leads to OAC initiation.

Main Methods:

• Prospective evaluation of 245 subjects with CHA2DS2-VASc score ≥2 and no prior AF history.
• AF screening using ICMs programmed for ≥6-minute episodes, with 18-month follow-up.
• Adjudication of events by cardiologists and review of subsequent OAC therapy.

Main Results:

• A 22.4% incidence of new-onset AF was detected during a mean follow-up of 451 days.
• The mean time to AF detection was 141.3 days.
• 76.4% of newly diagnosed AF patients were prescribed OACs.

Conclusions:

• In high-risk individuals (CHA2DS2-VASc ≥2), ICM screening identified new-onset AF in 22.4%.
• The majority of patients diagnosed with AF were initiated on OAC therapy.
• Insertable cardiac monitors show promise for AF screening in selected populations.