Abstract

BACKGROUND: Asymptomatic atrial fibrillation (AF) is associated with an increased risk of stroke. The yield of serial electrocardiographic (ECG) screening for AF is unknown.OBJECTIVES: The aim of this study was to determine the frequency of AF detected by serial, 7-day ECG patch screenings in older women identified as having an elevated risk of AF according to the CHARGE (Cohorts for Heart and Aging Research in Genomic Epidemiology)-AF clinical prediction score.METHODS: Postmenopausal women with a 5-year predicted risk of new-onset AF=5% according to CHARGE-AF were recruited from the ongoing WHISH (Women's Health Initiative Strong and Healthy) randomized trial of a physical activity intervention. Participants with AF at baseline by self-report or medical records review were excluded. Screening with 7-day ECG patch monitors was performed at baseline, 6months, and 12months from study enrollment.RESULTS: On baseline monitoring, 2.5% of the cohort had AF detected, increasing to 3.7% by 6months and 4.9% cumulatively by 12months. Yield of patch screening was higher among participants with a higher (=10%) CHARGE-AF score: 4.2% had AF detected at baseline, 5.9% at 6months, and 7.2% at 12months. Most participants with patch-identified AF never had a clinical diagnosis of AF (36 of 46 [78%]).CONCLUSIONS: Older women with an elevated CHARGE-AF score had a high prevalence of AF on 7-day ECG patch screening. Serial screening over 12months substantially increased the detection of AF. These data can be useful in helping identify high-risk participants for enrollment in future studies of the management of asymptomatic AF.(Women'sHealth Initiative Silent Atrial Fibrillation Recording Study [WHISH STAR]; NCT05366803.).

View details for DOI 10.1016/j.jacep.2022.08.024

View details for PubMedID 36543503