| 1. |
- Dziubiński, Marek J., et al.
(författare)
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Diagnostic yield is dependent on monitoring duration. Insights from a full-disclosure mobile cardiac telemetry system
- 2022
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Ingår i: Kardiologia Polska. - 0022-9032. ; 80:1, s. 56-63
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Tidskriftsartikel (refereegranskat)abstract
- Background: Despite the advancement of electrocardiogram (ECG) monitoring methods, the most important factor influencing diagnostic yield (DY) may still be monitoring duration. Ambulatory ECG monitoring, typically with 24–48 hours duration, is widely used but may result in underdiagnosis of rare arrhythmias. Aims: This study aimed to examine the relationship between the DY and monitoring duration in a large patient cohort and investigate sex and age differences in the presentation of arrhythmias. Methods: The study population consisted of 25 151 patients (57.8% women; median [interquartile range, IQR], 71 [64–78] years), who were examined with mobile cardiac telemetry during 2017 in the United States, using the PocketECGTM that continuously transmits a signal on a beat-to-beat basis. We investigated the occurrence of atrial fibrillation at a burden of both ≤1% (atrial fibrillation [AF], ≤1%) and ≤10% (AF ≤10%), premature ventricular contractions (PVC; >10 000 per 24 hours), non-sustained ventricular tachycardias (nsVT), sustained ventricular tachycardias (VT ≥30 seconds), atrioventricular blocks (AVB), pauses of >3 seconds duration, and bradycardia (heart rate <40 beats per minute for ≥60 seconds). Results: The median (IQR) recording duration was 15.4, 8.2–28.2) days. The DY increased gradually with monitoring duration for all types of investigated arrhythmias. Compared to DY after up to 30 days of monitoring, a standard 24 hours monitoring resulted in DY for males/females of 20%/18% for AF ≤1%, 29%/28% for AF ≤10%, 45%/40% for PVCs, 17%/11% for nsVT, 17%/11% for VT ≥30 seconds, 49%/42 for AVB, 27%/20% for pauses, 36%/29% for bradycardia. Conclusion: A substantial number of patients suffering from arrhythmias may remain undiagnosed due to insufficient ECG monitoring time.
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| 2. |
- Johnson, L., et al.
(författare)
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DIAGNOSTIC RELIABILITY OF MEASUREMENT OF PREMATURE VENTRICULAR COMPLEX FREQUENCY RELATED TO DURATION OF AMBULATORY MONITORING
- 2021
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Ingår i: Journal of the American College of Cardiology. - 1558-3597. ; 77:18, Suppl 1, s. 361-361
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Background Premature ventricular complexes (PVCs) are generally quantified using a 24h ECG recording, but the diagnostic accuracy is unknown. We aimed to determine the day-to-day variability and optimal monitoring duration for PVC measurements among patients with frequent PVCs. Methods We included all patients who underwent a clinical ambulatory ECG recording lasting 25-30 days, using the PocketECG device (Medi-Lynx, USA) during 2017, who did not have atrial fibrillation, and in whom ≥1000 PVCs were registered during one of the monitored days. All arrhythmias were manually verified. PVC variability was calculated as the percentage of the mean daily PVC count after full recording. Results The study population consisted of 1,376 individuals (median age 76.0 years, 53% men). Figure 1a shows the population distribution of the mean daily PVC counts. The mean daily PVC count was 2780 (standard deviation: 1556, range 0 - 56,262). A single-day PVC count differed by 69% from the mean daily count. After 18 days the obtained mean PVC count differed
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| 3. |
- Tan, Jian Liang, et al.
(författare)
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Sex differences in presentation of atrial fibrillation : Findings from 30-day ambulatory monitoring in real-world practice
- 2022
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Ingår i: American Heart Journal Plus: Cardiology Research and Practice. - : Elsevier BV. - 2666-6022. ; 22
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Tidskriftsartikel (refereegranskat)abstract
- Background: Women are less likely to receive oral anticoagulation or ablation for treatment of atrial fibrillation (AF). Identification of sex differences in arrhythmia characteristics and symptoms may lead to a better understanding of potential reasons for these differences. Objectives: To determine sex differences in AF with respect to heart rate, duration, burden, and symptoms in patients undergoing mobile cardiac telemetry (MCT) monitoring. Methods: All patients who registered for ≤30-day MCT using PocketECG (MediLynx) in the USA in 2017 were included (n = 27,512, 58 % women). PocketECG records and transmits a three-lead ambulatory electrocardiogram (ECG) with real-time beat-to-beat analysis. Sex-related differences were analyzed with Chi2 and Spearmans rho. Results: Fewer women than men were diagnosed with AF lasting ≥30s (13.7 % versus [vs] 19.0 %, p < 0.001). AF burden was lower in women in all age groups <90 years (all p < 0.01). Women were older at the time of AF diagnosis (median 76 vs 73 years, p < 0.001), had faster heart rate during AF (mean: 104.7 ± 26.0 vs 96.7 ± 26.7 bpm, p < 0.001), and shorter AF duration (mean: 96.2 ± 176.0 vs 121.6 ± 189.9 min, p < 0.001). There was a non-significant trend toward more symptoms (such as dizziness, racing heart, fatigue, or palpitations) during AF in women compared to men (46.5 % vs 43.7 %, p = 0.062). Conclusions: AF was less prevalent and occurred at lower burdens in women than men in each age strata. Despite faster heart rates in AF in women, there were no significant sex differences in reported symptoms during AF. Sex differences in therapy cannot be explained by differences in symptoms or rates in AF. Condensed abstract: Real-world data on sex differences in AF using a 30-day MCT monitoring device remain scarce. We aim to determine the sex differences in AF with respect to prevalence, burden, heart rate, and symptom in patients undergoing ≤30-day MCT monitoring. Our data analysis suggests that fewer women than men had AF, women were older at diagnosis of AF, and women with AF had higher mean heart rate, shorter mean AF duration, and lower mean AF burden than men. Further studies are needed to examine reasons for sex differences, specifically in relation to AF therapy and its impact on clinical outcomes.
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