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Fibrilación auricular subclínica en pacientes mayores

Jeff S Healey¹, Marco Alings², Andrew Ha²

¹From Population Health Research Institute, Hamilton, ON, Canada (J.S.H., J.W., D.L., H.D., K.S., S.R.M., S.J.C.); McMaster University, Hamilton, ON, Canada (J.S.H., J.W., D.L., H.D., W.F.M., S.R.M., A.S.P., S.J.C.); Amphia Ziekenhuis, Breda, the Netherlands (M.A.); WCN-Dutch Network for Cardiovascular Research (M.A.); University of Toronto, ON, Canada (A.H., A.V.); University of Western Ontario, London, Canada (P.L.-S.); University of Ottawa Heart Institute, ON, Canada (D.H.B.); Nij Smellinghe Hospital, Drachten, the Netherlands (J.J.d.G.); Ikazia Ziekenhuis, Rotterdam, the Netherlands (M.F.); Institut Universitaire de Cardiologie et de Pneumologie de Québec, QC, Canada (F.P.); University of Alberta, Edmonton, Canada (W.B.); University of Calgary, AB, Canada (M.D.H.); St. Jude Medical, Sylmar, CA (M.C.); Slingeland Ziekenhuis, Doetinchem, the Netherlands (F.S.); and Cambridge Cardiac Care Centre, ON, Canada (A.S.P.). Jeff.Healey@phri.ca.

|August 6, 2017

Resumen

La fibrilación auricular subclínica (FAC) es común en pacientes mayores sin antecedentes de FA, detectada mediante monitorización continua del ECG. Se necesita más investigación para comprender la importancia clínica de estos hallazgos del SCAF.

Área de la Ciencia:

Cardiología
Neurología
Dispositivos médicos

Sus antecedentes:

Se conoce la prevalencia de la fibrilación auricular subclínica (FAC) en pacientes con marcapasos y accidentes cerebrovasculares criptogénicos.
La prevalencia de FASC en otros grupos de pacientes sin estas afecciones sigue siendo desconocida.

Objetivo del estudio:

Investigar la prevalencia de FASC en pacientes mayores sin antecedentes de fibrilación auricular que asisten a clínicas cardiovasculares o neurológicas.

Principales métodos:

Monitores de ECG subcutáneos implantados (St. Jude CONFIRM- AF) en pacientes de 65 años o más.
Se incluyeron pacientes con una puntuación CHA < sub> 2 DS < sub> 2 -VASc ≥ 2, apnea del sueño o IMC > 30 kg/ m < sup> 2.
La elegibilidad también requería agrandamiento auricular izquierdo o aumento de NT-proBNP; monitoreado para SCAF ≥5 minutos.

Principales resultados:

Se detectó FASC en el 34,4% de los 256 pacientes durante 16,3 meses.
Los predictores de FAS incluyen la edad avanzada, la dimensión auricular izquierda más grande y la presión arterial.
La tasa de detección de FASC fue mayor en pacientes con volumen auricular izquierdo por encima de la mediana.

Conclusiones:

SCAF se detecta con frecuencia en pacientes mayores que asisten a clínicas de cardiología y neurología sin antecedentes de FA.
La importancia clínica de la FASC detectada no está clara.

Palabras clave:

Fibrilación auricular Monitoreo fisiológico el golpe

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