There is very little association between clinical classification of AF (paroxysmal, persistent, or permanent) and various clinical manifestations (symptoms/lack of symptoms, different patient thresholds for seeking medical attention and subsequent rhythm documentation, and different thresholds for cardioversion attempts). Most AF episodes are not noted by the patient, or they manifest with nonspecific symptoms such as fatigue or impaired exercise capacity. The current American Heart Association (AHA) and American College of Cardiology (ACC) guidelines categorize AF into three forms: paroxysmal AF (intermittent, stopping spontaneously 7 days or terminated by pharmacological or electrical cardioversion), and permanent AF (cardioversion unsuccessful or considered of no use). Since adequate anticoagulation therapy can decrease the risk of ischemic stroke in patients with AF by more than 70%, it is clear that early detection and treatment of AF is essential. ĪF is associated with a 5-fold increase in stroke risk and a doubled risk of mortality. Owing to lifestyle habits, and to the increased prevalence of metabolic disease and hypertension, AF diagnosis is made with increasing frequency in younger patients (“lone atrial fibrillation”, without structural heart disease). The prevalence is highly age-dependent, and climbs to 10% in 80- to 89-year-old patients. Currently, about 0.5–1% of the total population is affected. Having received funding does not alter the authors' adherence to all the PLOS ONE policies on sharing data and materials.Ītrial fibrillation (AF) is by far the most common cardiac rhythm disorder seen in clinical practice. The study was funded by Sanofi, Berlin, Germany, and one of the authors is employed by the company. David Pittrow has received consultancy honoraria from Sanofi-Aventis, Berlin. Thomas Hepp is a full-time employee of the Apoplex Medical Technologies. Ludger Rosin is a full-time employee of Sanofi-Aventis GmbH. Schaefer serves as medical advisor for MSD-ESSEX, Genzyme and Aergerion and received lecture honoraria from MSD-ESSEX, Genzyme, B. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.Ĭompeting interests: Jürgen R. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.įunding: The study was funded by Sanofi-Aventis, Berlin. Received: OctoAccepted: JanuPublished: February 28, 2014Ĭopyright: © 2014 Schaefer et al. Schnabel, University Heart Center, Germany SRA detected almost all cardiologist-confirmed AF episodes that had been recorded in 1-hour ECG snips (sensitivity, 99.2% specificity, 99.2%).Ĭitation: Schaefer JR, Leussler D, Rosin L, Pittrow D, Hepp T (2014) Improved Detection of Paroxysmal Atrial Fibrillation Utilizing a Software-Assisted Electrocardiogram Approach. For these patients, SRA classified 77.8% as being at risk in the first hour after the end of the AF episode, and 71.4% and 42.9% as being at risk in the second and third hours, respectively. The Holter data showed at least 1 AF episode and at least 1 hour of sinus rhythm in nine of the patients with pAF. SRA detected pAF risk in 23 of these 54 patients (representing a sensitivity of 42.6%). Fifty-four of the 70 patients also showed a sinus rhythm in the first hour. AF episodes were detected by Holter ECG in 19 of the 70 non-chronic AF patients (27.1% overall, 18.6% in the first hour), and 37 of these 70 patients were classified as at risk for pAF by SRA (representing a sensitivity of 52.9% based on the first hour of analyzed recording). Data from 12-lead ECGs, 24-h Holter ECGs, and SRA based on separate 1-hour Holter ECG snips were collected from three groups: 70 patients with a history of pAF but who showed no AF episode in the 12-lead ECG at study entry 19 patients with chronic AF (at study entry) and 100 young healthy individuals.
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