Dataset Information

Episodes of Atrial Fibrillation and Symptoms: A Temporal Analysis.

ABSTRACT:

Background

Data on the relationship between symptoms and atrial fibrillation (AF) episodes are limited.

Objective

The objective of this study was to determine the strength of temporal association between AF episodes and symptoms.

Methods

This cross-sectional ambulatory assessment study was performed in a tertiary care center between June 2018 and December 2021. Patients with paroxysmal AF (1 episode of AF, burden not exceeding 95%) who used a mobile application and continuous wearable electrocardiogram monitor for 21 days were enrolled. The primary outcome was worse symptoms (symptoms above the mean score) over the study period. The association between worse symptoms and the presence of AF was evaluated for different time epochs. Multilevel mixed-effects models were used to quantify associations after accounting for confounders.

Results

Worse symptoms were more likely to be associated with the presence of AF episodes 15 minutes prior to the reporting of palpitations (OR, 2.8 [95% CI, 1.6-5.0]; P < .001), shortness of breath (OR, 2.2 [95% CI, 1.3-3.7]; P = .003), dizziness/lightheadedness (OR, 2.0 [95% CI, 1.0-3.7]; P = .04), and fatigue (OR, 1.7 [95% CI, 1.0-2.9]; P = .03). The correlation between the severity of symptoms and AF lessened as the time interval from AF events to symptoms increased.

Conclusion

There is a significant relationship between onset of AF episodes and reporting of symptoms. This association diminishes over time and varies across different symptoms. If confirmed in larger studies, these findings may inform AF interventions that target symptoms just in time prior to a clinical visit.

SUBMITTER: Ghanbari H

PROVIDER: S-EPMC10577487 | biostudies-literature | 2023 Oct

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Episodes of Atrial Fibrillation and Symptoms: A Temporal Analysis.

Ghanbari Hamid H Whibley Daniel D Lehmann H Immo HI Li Zhi Z Kratz Anna A Clauw Daniel J DJ Nallamothu Brahmajee K BK

Cardiovascular digital health journal 20230707 5

<h4>Background</h4>Data on the relationship between symptoms and atrial fibrillation (AF) episodes are limited.<h4>Objective</h4>The objective of this study was to determine the strength of temporal association between AF episodes and symptoms.<h4>Methods</h4>This cross-sectional ambulatory assessment study was performed in a tertiary care center between June 2018 and December 2021. Patients with paroxysmal AF (1 episode of AF, burden not exceeding 95%) who used a mobile application and continuo ...[more]

PMID: 37850044

Similar Datasets

Project description:ImportanceUnderstanding the temporal association between atrial fibrillation (AF) and ischemic stroke informs our understanding of the AF-stroke mechanism and treatment of paroxysmal AF.ObjectiveTo define the temporal association between episodes of AF and stroke in patients with cardiac implantable electronic devices (CIEDs).Design, setting, and participantsIn this case-crossover study, data from a large national electronic health record database were linked with a single-vendor database of heart rhythm records of patients with CIEDs capable of continuous heart rhythm monitoring. Patients with CIEDs who sustained an ischemic stroke who also had 120 days of continuous remote rhythm monitoring prestroke were included. Data were collected from January 2007 to March 2017, and data were analyzed from November 2019 to June 2020.ExposureAF for 5.5 hours or more on any given day during days 1 to 30 vs days 91 to 120 prestroke.Main outcomes and measuresOdds ratio for stroke comparing AF during days 1 to 30 vs 91 to 120 prestroke. This analysis was planned prior to the study.ResultsFrom 466 635 patients included in both the Optum electronic health record and CareLink databases, 891 patients with CIEDs and ischemic stroke with continuous monitoring in the 120 days prestroke were identified. Of 891 included patients, 575 (64.5%) were male, and the median (interquartile range) age was 76 (67-82) years. The vast majority of patients with stroke had either no AF meeting the threshold duration of 5.5 hours or more in both the case and control periods (682 of 891 [76.5%]) or AF of 5.5 hours or more in both periods (143 of 891 [16.0%]). For those not meeting the 5.5-hour AF threshold in either period, there was no or very little AF throughout the 120 days prestroke. A total of 66 patients had informative, discordant arrhythmic states, with 52 having AF of 5.5 hours or more in the case period vs 14 in the control period (odds ratio [OR], 3.71; 95% CI, 2.06-6.70). Stroke risk was increased most in days 1 to 5 following an AF episode (OR, 5.00; 95% CI, 2.62-9.55). AF greater than 23 hours on a given day was associated with the clearest increase in stroke risk (OR, 5.00; 95% CI, 2.08-12.01).Conclusions and relevanceIn this large cohort of patients with CIEDs and continuous rhythm monitoring prior to ischemic stroke, excess stroke risk above baseline was highest within 5 days of an episode of AF of 5.5 hours or more in duration and diminished rapidly thereafter. Our findings are consistent with the traditional view that AF is directly and transiently associated with ischemic stroke. These results provide support for trials of time-delimited anticoagulation for patients with infrequent multihour episodes of AF and rigorous, continuous rhythm monitoring.

Dataset Information

Episodes of Atrial Fibrillation and Symptoms: A Temporal Analysis.

Background

Objective

Methods

Results

Conclusion

Publications

Episodes of Atrial Fibrillation and Symptoms: A Temporal Analysis.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets