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Atrial fibrillation detection with long-term continuous Holter ECG recording in patients with high cardiovascular risk and clinical palpitations: the prospective after study

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Abstract

Aim

New technologic tools for continuous ECG monitoring have been developed to detect and treat atrial fibrillation (AF) in specific populations with high cardiovascular risk. We evaluated the prevalence and the management of AF diagnosed in patients with high cardiovascular risk and non-documented clinical palpitation undergoing systematic 14-day continuous ECG–Holter monitoring.

Methods

Patients were prospectively enrolled from December 2019 to December 2021 in this multicentre study, sponsored by the French National College of Cardiology. Patients met the following criteria: CHA2DS2VASc score ≥ 2 in males and ≥ 3 in females and clinical palpitations without previously documented arrhythmia. Enrolled patients underwent a continuous 14-day Holter–ECG monitoring for arrhythmia detection.

Results

Among the 336 included patients, 39% were male, 75% were greater than 65 years of age and 46.5% had suffered a prior stroke. AF was detected in 14% of patients, among which 23.4% were detected in the first 24 h of monitoring. Finally, age ≥ 65 years (p = 0.037) was significantly associated with AF, as well as male gender (p = 0.023) and a lower rate of antiplatelet therapy (p = 0.018). Patients with diagnosed AF had a prescription of anticoagulation therapy in 90%. Antiarrhythmic drugs were administered in 90% of AF patients and 13% underwent AF ablation.

Conclusions

The systematic AF screening of patients with palpitations and high cardiovascular risk resulted in a diagnostic yield of AF in 14% of the population with a 14-day continuous ECG–Holter monitor. This strategy resulted in the prescription of anticoagulation and antiarrhythmic therapy in 90% of the AF detected population.

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Abbreviations

AF:

Atrial fibrillation

ICD:

Implantable cardioverter–defibrillator

ILR:

Implantable loop recorder

PM:

Pace-maker

SVT:

Supraventricular tachycardia

VT:

Ventricular tachycardia

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Funding

This study was supported by a grant from BMS-Pfizer company.

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Authors and Affiliations

  1. Hôpital Privé, Parly 2, 21 rue Moxouris, 78150, Le Chesnay, France

    F. Halimi

  2. Department of Cardiology, AP-HP, University Hospital Pitié-Salpétrière, Creteil, France

    P. Sabouret

  3. French College of Cardiology, 75014, Paris, France

    J. P. Huberman, L. Ouazana & D. Guedj

  4. Department of Cardiology, AP-HP, University Hospital Henri Mondor, 51, Avenue du Maréchal de Lattre de Tassigny, 94000, Creteil, France

    K. Djouadi & Nicolas Lellouche

  5. Department of Cardiac Electrophysiology, University of Warwick, Gibbet Hill, Coventry, UK

    T. S. Dhanjal

  6. Department of Cardiac Electrophysiology, St Vincenz Kliniken, Paderborn, Germany

    A. Goette

  7. Univ Paris Est Creteil, INSERM, IMRB, 94010, Creteil, France

    C. Lafont

  8. Service de Santé Publique, AP-HP, Hôpital Henri-Mondor, 94010, Créteil, France

    C. Lafont

Authors
  1. F. Halimi
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  2. P. Sabouret
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  4. L. Ouazana
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  5. D. Guedj
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  7. T. S. Dhanjal
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  8. A. Goette
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  9. C. Lafont
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  10. Nicolas Lellouche
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Corresponding author

Correspondence to Nicolas Lellouche.

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All the authors declare no conflict of interest for this study.

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Halimi, F., Sabouret, P., Huberman, J.P. et al. Atrial fibrillation detection with long-term continuous Holter ECG recording in patients with high cardiovascular risk and clinical palpitations: the prospective after study. Clin Res Cardiol 112, 807–814 (2023). https://doi.org/10.1007/s00392-022-02109-9

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  • DOI: https://doi.org/10.1007/s00392-022-02109-9

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