Duration of device-detected subclinical atrial fibrillation and occurrence of stroke in ASSERT

Isabelle C. Van Gelder; Jeff S. Healey; Harry J. G. M. Crijns; Jia Wang; Stefan H. Hohnloser; Michael R. Gold; Alessandro Capucci; Chu-Pak Lau; Carlos A. Morillo; Anne H. Hobbelt; Michiel Rienstra; Stuart J. Connolly

doi:10.1093/eurheartj/ehx042

Duration of device-detected subclinical atrial fibrillation and occurrence of stroke in ASSERT

Isabelle C. Van Gelder^*, Jeff S. Healey, Harry J. G. M. Crijns, Jia Wang, Stefan H. Hohnloser, Michael R. Gold, Alessandro Capucci, Chu-Pak Lau, Carlos A. Morillo, Anne H. Hobbelt, Michiel Rienstra, Stuart J. Connolly

^*Corresponding author for this work

Cardiologie

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

Background ASSERT demonstrated that subclinical atrial fibrillation (SCAF) is common in pacemaker patients without prior AF and is associated with increased risk of ischemic stroke or systemic embolism. SCAF episodes vary in duration and little is known about the incidence of different durations of SCAF, or their prognosis.

Methods and results ASSERT followed 2580 patients receiving a pacemaker or ICD, aged >65 years with hypertension, without prior AF. The effect of SCAF duration on subsequent risk of ischemic stroke or embolism was evaluated with time-dependent covariate Cox models. Patients in whom the longest SCAF was 6 min to 6 h in 462 patients (18.8%), >6-24 h in 169 (6.9%), and >24 h in 262 (10.7%). SCAF duration >24 h was associated with a significant increased risk of subsequent stroke or systemic embolism (adjusted hazard ratio [HR] 3.24, 95% confidence interval [CI] 1.51-6.95, P=0.003). The risk of ischemic stroke or systemic embolism in patients with SCAF between 6 min and 24 h was not significantly different from patients without SCAF.

Conclusions SCAF >24 h is associated with an increased risk of ischemic stroke or systemic embolism.

Original language	English
Pages (from-to)	1339-1344
Number of pages	6
Journal	European Heart Journal
Volume	38
Issue number	17
DOIs	https://doi.org/10.1093/eurheartj/ehx042
Publication status	Published - 1 May 2017

Keywords

TEMPORAL RELATIONSHIP
EMBOLIC EVENTS
PROGRESSION
RISK
REGISTRY
RHYTHM
PROGNOSIS
COHORT
TRIAL
MORTALITY

Access to Document

10.1093/eurheartj/ehx042

Cite this

Van Gelder, I. C., Healey, J. S., Crijns, H. J. G. M., Wang, J., Hohnloser, S. H., Gold, M. R., Capucci, A., Lau, C.-P., Morillo, C. A., Hobbelt, A. H., Rienstra, M., & Connolly, S. J. (2017). Duration of device-detected subclinical atrial fibrillation and occurrence of stroke in ASSERT. European Heart Journal, 38(17), 1339-1344. https://doi.org/10.1093/eurheartj/ehx042

@article{da172799dd194e4285443b2f49e9d205,

title = "Duration of device-detected subclinical atrial fibrillation and occurrence of stroke in ASSERT",

abstract = "Background ASSERT demonstrated that subclinical atrial fibrillation (SCAF) is common in pacemaker patients without prior AF and is associated with increased risk of ischemic stroke or systemic embolism. SCAF episodes vary in duration and little is known about the incidence of different durations of SCAF, or their prognosis.Methods and results ASSERT followed 2580 patients receiving a pacemaker or ICD, aged >65 years with hypertension, without prior AF. The effect of SCAF duration on subsequent risk of ischemic stroke or embolism was evaluated with time-dependent covariate Cox models. Patients in whom the longest SCAF was 6 min to 6 h in 462 patients (18.8%), >6-24 h in 169 (6.9%), and >24 h in 262 (10.7%). SCAF duration >24 h was associated with a significant increased risk of subsequent stroke or systemic embolism (adjusted hazard ratio [HR] 3.24, 95% confidence interval [CI] 1.51-6.95, P=0.003). The risk of ischemic stroke or systemic embolism in patients with SCAF between 6 min and 24 h was not significantly different from patients without SCAF.Conclusions SCAF >24 h is associated with an increased risk of ischemic stroke or systemic embolism.",

keywords = "TEMPORAL RELATIONSHIP, EMBOLIC EVENTS, PROGRESSION, RISK, REGISTRY, RHYTHM, PROGNOSIS, COHORT, TRIAL, MORTALITY",

author = "{Van Gelder}, {Isabelle C.} and Healey, {Jeff S.} and Crijns, {Harry J. G. M.} and Jia Wang and Hohnloser, {Stefan H.} and Gold, {Michael R.} and Alessandro Capucci and Chu-Pak Lau and Morillo, {Carlos A.} and Hobbelt, {Anne H.} and Michiel Rienstra and Connolly, {Stuart J.}",

year = "2017",

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doi = "10.1093/eurheartj/ehx042",

language = "English",

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TY - JOUR

T1 - Duration of device-detected subclinical atrial fibrillation and occurrence of stroke in ASSERT

AU - Van Gelder, Isabelle C.

AU - Healey, Jeff S.

AU - Crijns, Harry J. G. M.

AU - Wang, Jia

AU - Hohnloser, Stefan H.

AU - Gold, Michael R.

AU - Capucci, Alessandro

AU - Lau, Chu-Pak

AU - Morillo, Carlos A.

AU - Hobbelt, Anne H.

AU - Rienstra, Michiel

AU - Connolly, Stuart J.

PY - 2017/5/1

Y1 - 2017/5/1

N2 - Background ASSERT demonstrated that subclinical atrial fibrillation (SCAF) is common in pacemaker patients without prior AF and is associated with increased risk of ischemic stroke or systemic embolism. SCAF episodes vary in duration and little is known about the incidence of different durations of SCAF, or their prognosis.Methods and results ASSERT followed 2580 patients receiving a pacemaker or ICD, aged >65 years with hypertension, without prior AF. The effect of SCAF duration on subsequent risk of ischemic stroke or embolism was evaluated with time-dependent covariate Cox models. Patients in whom the longest SCAF was 6 min to 6 h in 462 patients (18.8%), >6-24 h in 169 (6.9%), and >24 h in 262 (10.7%). SCAF duration >24 h was associated with a significant increased risk of subsequent stroke or systemic embolism (adjusted hazard ratio [HR] 3.24, 95% confidence interval [CI] 1.51-6.95, P=0.003). The risk of ischemic stroke or systemic embolism in patients with SCAF between 6 min and 24 h was not significantly different from patients without SCAF.Conclusions SCAF >24 h is associated with an increased risk of ischemic stroke or systemic embolism.

AB - Background ASSERT demonstrated that subclinical atrial fibrillation (SCAF) is common in pacemaker patients without prior AF and is associated with increased risk of ischemic stroke or systemic embolism. SCAF episodes vary in duration and little is known about the incidence of different durations of SCAF, or their prognosis.Methods and results ASSERT followed 2580 patients receiving a pacemaker or ICD, aged >65 years with hypertension, without prior AF. The effect of SCAF duration on subsequent risk of ischemic stroke or embolism was evaluated with time-dependent covariate Cox models. Patients in whom the longest SCAF was 6 min to 6 h in 462 patients (18.8%), >6-24 h in 169 (6.9%), and >24 h in 262 (10.7%). SCAF duration >24 h was associated with a significant increased risk of subsequent stroke or systemic embolism (adjusted hazard ratio [HR] 3.24, 95% confidence interval [CI] 1.51-6.95, P=0.003). The risk of ischemic stroke or systemic embolism in patients with SCAF between 6 min and 24 h was not significantly different from patients without SCAF.Conclusions SCAF >24 h is associated with an increased risk of ischemic stroke or systemic embolism.

KW - TEMPORAL RELATIONSHIP

KW - EMBOLIC EVENTS

KW - PROGRESSION

KW - RISK

KW - REGISTRY

KW - RHYTHM

KW - PROGNOSIS

KW - COHORT

KW - TRIAL

KW - MORTALITY

U2 - 10.1093/eurheartj/ehx042

DO - 10.1093/eurheartj/ehx042

M3 - Article

SN - 0195-668X

VL - 38

SP - 1339

EP - 1344

JO - European Heart Journal

JF - European Heart Journal

IS - 17

ER -