Electrocardiographic markers of subclinical atrial fibrillation detected by implantable loop recorder

Abstract Funding Acknowledgements Type of funding sources: Foundation. Main source(s): The LOOP Study was funded by Innovation Fund Denmark [grant number 12-1352259], Research Foundation for the Capital Region Denmark, Danish Heart 11-04-R83-A3363-22625], Aalborg University Talent Management Program, Arvid Nilssons Fond, Skibsreder Per Henriksen, R og Hustrus European Union’s Horizon 2020 program 847770], Læge Sophus Carl Emil Friis hustru Olga Doris Friis’ Legat, and an unrestricted grant from Medtronic. Background Atrial fibrillation (AF) is a well-known treatable risk factor stroke, which has sparked substantial interest in AF screening. However, further insights into subclinical development are warranted to inform strategies screening subsequent clinical management upon detection. Purpose This study sought identify 12-lead electrocardiogram (ECG) parameters associated with onset, burden progression detected long-term continuous monitoring. Methods We included AF-naïve individuals aged 70-90 years ≥1 additional stroke factors (hypertension, diabetes, heart failure, or prior stroke) who underwent implantable loop recorder (ILR) monitoring Study. Using data daily ILR recordings computerized analysis baseline ECG, we studied empirically selected ECG detection (≥6 minutes), cumulative burden, long-lasting (≥24 hours), progression. Results Of 1370 included, 419 (30.6%) developed during follow-up, mean 1.5% [95% confidence interval (CI): 1.2-1.8%]. Several P-wave-related ventricular were new-onset as well patients. P-wave duration (PWD), terminal force lead V1, interatrial block (IAB) demonstrated significant associations episode ≥24 hours. Among patients, observed overall reduction over time (incidence rate ratio 0.70 CI: 0.51-0.96]), whereas IAB related increased episodes hours (hazard 1.86 1.02-3.39]). Further spline revealed longer PWD also be this duration. Conclusions identified several ILR. Especially robustly onset time.