Device-detected atrial fibrillation before and after acute cardiac events: insights from ASSERT. (24th May 2021)

• Record Type: Journal Article
• Authors: Mcintyre, WF; Wang, J; Belley-Cote, EP; Roberts, JD; Benz, AP; Conen, D; Devereaux, PJ; Wong, JA; Wang, MK; Whitlock, RP; Connolly, SJ; Healey, JS
• Is Part Of: Europace. Volume 23:Supplement 3(2021)
• Publication Date: 2021-05-24
• Subjects: Arrhythmia -- Treatment -- Periodicals; Cardiac pacing -- Periodicals; Catheter ablation -- Periodicals; Heart -- Physiology -- Periodicals; Electrophysiology -- Periodicals; 617.4120645
• DOI: 10.1093/europace/euab116.139
• Languages: English
• ISSNs: 1099-5129

Abstract

Abstract: Funding Acknowledgements: Type of funding sources: None. Background: Atrial fibrillation (AF) that is first detected concurrently with or shortly after another cardiac event is often thought to be caused by acute cardiac injury, and therefore reversible. Methods: ASSERT enrolled patients >65 years old with hypertension and a pacemaker, but without known AF. We evaluated participants who had a cardiac event [angina/myocardial infarction (MI), cardiac catheterization/percutaneous coronary intervention (PCI), cardiac surgery or other (e.g. pericarditis, hypertensive crisis)] and compared the prevalence of device-detected AF before and after these events. Results: Among 2580 participants, 178 (6.9%) had at least one cardiac event over a mean 2.5 years of follow-up. In the 30 days following a first cardiac event, the prevalence of device-detected AF >6 min was 12.4% (95% confidence interval [CI] 7.9%-18.1%), which was higher than in the 30 days before the event (12.4% versus 4.5%, P = 0.004) (Figure 1). The prevalence of device-detected AF following the event was comparable across event subtypes (MI: 13.8%, 95%CI 7.9-18.1%; PCI: 6.9%, 95%CI 1.9-16.7%; Surgery: 20.0%, 95%CI 5.7-43.7%; Other: 18.5%, 95%CI 6.3-38.1%). There was a significant association between device-detected AF in the 6 months before a cardiac event and device-detected AF in the 30 days after a cardiac event: odds ratio (OR, adjusted for CHA2DS2-VASc score) for episodes >6 min 7.07 (95%CI 2.07-24.19; P = 0.002); adjusted OR for episodes >24 hours: 11.41 (95%CI 1.47-88.43; p = 0.020). Conclusions: Acute cardiac events are associated with an increase in the prevalence of device-detected AF. These episodes are associated with a prior history of device-detected AF.