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Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation
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Brief episodes of rapid irregular atrial activity (micro-AF) are a risk marker for atrial fibrillation: a prospective

Tove Fredriksson1, Katrin Kemp Gudmundsdottir2, Viveka Frykman2

  • 1Department of Clinical Sciences, Karolinska Institutet, Danderyd University Hospital, 182 88, Stockholm, Sweden. tove.fredriksson@sll.se.

BMC Cardiovascular Disorders
|April 12, 2020
PubMed
Abstract

Insights

Short episodes of atrial fibrillation-like activity (micro-AF) can indicate undiagnosed silent atrial fibrillation (AF). Continuous screening is recommended for individuals with micro-AF, as it significantly increases the likelihood of detecting AF.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Preventive Medicine

Background:

  • Short supraventricular tachycardias with atrial fibrillation (AF) characteristics are linked to a higher risk of developing AF.
  • Undiagnosed silent atrial fibrillation poses a significant health risk.

Purpose of the Study:

  • To determine if very short-lasting episodes of AF-like activity (micro-AF) can serve as a marker for undiagnosed silent atrial fibrillation.
  • To assess the prevalence of micro-AF in an elderly population screened for AF.

Main Methods:

  • The STROKESTOP II study screened 75- and 76-year-olds with elevated NT-proBNP using intermittent ECGs.
  • Participants with micro-AF (defined as irregular tachycardia with absence of P-waves, <30s) underwent extended continuous ECG monitoring.
  • A control group without micro-AF was also monitored.

Main Results:

  • 6% of participants (221/3763) with elevated NT-proBNP and no prior AF diagnosis had micro-AF.
  • AF was detected in 26/196 (13%) of the micro-AF group during extended monitoring.
  • AF was detected in 7/250 (3%) of the control group, a statistically significant difference (p < 0.001).

Conclusions:

  • The presence of micro-AF suggests a higher likelihood of undetected atrial fibrillation.
  • Continuous ECG screening is recommended for individuals with micro-AF, especially if AF detection influences clinical management.
Keywords:
Atrial fibrillationElectrocardiogramMicro-AFScreeningSupraventricular ectopic beatsSupraventricular tachycardia

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