Screening of Atrial Fibrillation/Arrhythmia Events in Patients With Abnormal ECHOcardiographic Parameters: The...

Area of Science:

• Cardiology
• Medical Diagnostics
• Clinical Trials

Background:

• Atrial fibrillation (AF) is often asymptomatic and paroxysmal, necessitating effective screening methods.
• Abnormal echocardiographic parameters are linked to AF but not yet used for screening.
• Existing screening methods may miss early or intermittent AF.

Purpose of the Study:

• To evaluate the feasibility of using specific echocardiographic parameters for AF screening.
• To assess the AF detection rate using extended electrocardiogram (ECG) monitoring in patients meeting echocardiographic criteria.
• To inform future strategies for AF screening.

Main Methods:

• Prospective, randomized, open-label, multicenter trial (SAFE-ECHO study).
• Patients without AF but with echocardiographic criteria (LAE, LVH, E/e' > 14, diastolic dysfunction, VHD, HF) were randomized.
• Intervention group received proactive staged screening with 30-second ECG and 7-day continuous ECG monitoring every 3 months for 1 year.

Main Results:

• The primary endpoint is the detection of new-onset AF within the 12-month screening period.
• Secondary endpoint: detection of clinically significant arrhythmias.
• Tertiary endpoint (exploratory): composite of major adverse cardiovascular events.

Conclusions:

• The study aims to determine if echocardiographic parameters can serve as effective criteria for AF screening.
• It will assess the yield of scheduled extended ECG monitoring for AF detection.
• Findings may guide the development of novel AF screening protocols.