P6543Screen-detected atrial fibrillation in a one-minute single-lead ECG predicts mortality in elderly subjects

P6543Screen-detected atrial fibrillation in a one-minute single-lead ECG predicts mortality in elderly subjects

Abstract Background Atrial fibrillation (AF) is the most common arrhythmia associated with increased morbidity and mortality. Current guidelines recommend opportunistic screening for AF but the prognostic impact of screen-detected AF is unclear. Methods We performed a 4-week, prospective, pharmacy-b...

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Veröffentlicht in:European heart journal 2019-10, Vol.40 (Supplement_1)
Hauptverfasser: Zink, M D, Mischke, K, Keszei, A, Rummey, C, Freedman, B, Neumann, G, Tolksdorf, A, Frank, F, Wienstroer, J, Kuth, N, Schulz, J B, Marx, N
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container_title European heart journal
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creator Zink, M D
Mischke, K
Keszei, A
Rummey, C
Freedman, B
Neumann, G
Tolksdorf, A
Frank, F
Wienstroer, J
Kuth, N
Schulz, J B
Marx, N
description Abstract Background Atrial fibrillation (AF) is the most common arrhythmia associated with increased morbidity and mortality. Current guidelines recommend opportunistic screening for AF but the prognostic impact of screen-detected AF is unclear. Methods We performed a 4-week, prospective, pharmacy-based AF screening study in 7107 elderly citizens (≥65 years) using a hand-held, automated, one-minute single-lead ECG (SL-ECG) recording device. Prevalence and incidence of AF was assessed, and data on all-cause death and hospitalization for cardiovascular (CV) causes were collected over a median follow-up of 401 (372; 435) days. Results Automated SL-ECG analyses revealed heartbeat irregularities suspicious of AF in 432 (6.1%) participants with newly diagnosed AF in 3.6% of all subjects. During follow-up, 62 participants (0.9%) died and 390 (6.0%) were hospitalised for CV causes. Total mortality was 2.3% in participants with a SL-ECG suspicious of AF and 0.8% in subjects with a normal SL-ECG (HR 2.93; 95% CI: 1.49, 5.77; P=0.002, Figure 1A); hospitalization for CV causes occurred in 10.6% and 5.5%, respectively (HR 2.08; 95% CI: 1.52, 2.84; P
doi_str_mv 10.1093/eurheartj/ehz746.1133
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Current guidelines recommend opportunistic screening for AF but the prognostic impact of screen-detected AF is unclear. Methods We performed a 4-week, prospective, pharmacy-based AF screening study in 7107 elderly citizens (≥65 years) using a hand-held, automated, one-minute single-lead ECG (SL-ECG) recording device. Prevalence and incidence of AF was assessed, and data on all-cause death and hospitalization for cardiovascular (CV) causes were collected over a median follow-up of 401 (372; 435) days. Results Automated SL-ECG analyses revealed heartbeat irregularities suspicious of AF in 432 (6.1%) participants with newly diagnosed AF in 3.6% of all subjects. During follow-up, 62 participants (0.9%) died and 390 (6.0%) were hospitalised for CV causes. Total mortality was 2.3% in participants with a SL-ECG suspicious of AF and 0.8% in subjects with a normal SL-ECG (HR 2.93; 95% CI: 1.49, 5.77; P=0.002, Figure 1A); hospitalization for CV causes occurred in 10.6% and 5.5%, respectively (HR 2.08; 95% CI: 1.52, 2.84; P&lt;0.001, Figure 1B). Compared with subjects without a history of AF at baseline and a normal SL-ECG, participants with newly diagnosed AF or known AF had a significantly higher mortality risk with HRs of 2.63 (95% CI: 1.04, 6.63; p=0.04) and 2.68 (95% CI: 1.45, 4.98; p=0.002), respectively. After multivariable adjustment, a SL-ECG recording suspicious of AF remained a significant predictor of death or hospitalization for CV causes. Figure 1 Conclusions Pharmacy-based, automated, one-minute SL-ECG screening in elderly citizens identified subjects with unknown AF and an excess mortality risk over the next one year. Acknowledgement/Funding Unrestricted research grant by Pfizer/BMS. Matthias Zink received a DGK electrophysiology grant (funded by St. Jude Medical).</description><identifier>ISSN: 0195-668X</identifier><identifier>EISSN: 1522-9645</identifier><identifier>DOI: 10.1093/eurheartj/ehz746.1133</identifier><language>eng</language><publisher>Oxford University Press</publisher><ispartof>European heart journal, 2019-10, Vol.40 (Supplement_1)</ispartof><rights>Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2019. For permissions, please email: journals.permissions@oup.com. 2019</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,1578,27903,27904</link.rule.ids></links><search><creatorcontrib>Zink, M D</creatorcontrib><creatorcontrib>Mischke, K</creatorcontrib><creatorcontrib>Keszei, A</creatorcontrib><creatorcontrib>Rummey, C</creatorcontrib><creatorcontrib>Freedman, B</creatorcontrib><creatorcontrib>Neumann, G</creatorcontrib><creatorcontrib>Tolksdorf, A</creatorcontrib><creatorcontrib>Frank, F</creatorcontrib><creatorcontrib>Wienstroer, J</creatorcontrib><creatorcontrib>Kuth, N</creatorcontrib><creatorcontrib>Schulz, J B</creatorcontrib><creatorcontrib>Marx, N</creatorcontrib><title>P6543Screen-detected atrial fibrillation in a one-minute single-lead ECG predicts mortality in elderly subjects</title><title>European heart journal</title><description>Abstract Background Atrial fibrillation (AF) is the most common arrhythmia associated with increased morbidity and mortality. Current guidelines recommend opportunistic screening for AF but the prognostic impact of screen-detected AF is unclear. Methods We performed a 4-week, prospective, pharmacy-based AF screening study in 7107 elderly citizens (≥65 years) using a hand-held, automated, one-minute single-lead ECG (SL-ECG) recording device. Prevalence and incidence of AF was assessed, and data on all-cause death and hospitalization for cardiovascular (CV) causes were collected over a median follow-up of 401 (372; 435) days. Results Automated SL-ECG analyses revealed heartbeat irregularities suspicious of AF in 432 (6.1%) participants with newly diagnosed AF in 3.6% of all subjects. During follow-up, 62 participants (0.9%) died and 390 (6.0%) were hospitalised for CV causes. Total mortality was 2.3% in participants with a SL-ECG suspicious of AF and 0.8% in subjects with a normal SL-ECG (HR 2.93; 95% CI: 1.49, 5.77; P=0.002, Figure 1A); hospitalization for CV causes occurred in 10.6% and 5.5%, respectively (HR 2.08; 95% CI: 1.52, 2.84; P&lt;0.001, Figure 1B). Compared with subjects without a history of AF at baseline and a normal SL-ECG, participants with newly diagnosed AF or known AF had a significantly higher mortality risk with HRs of 2.63 (95% CI: 1.04, 6.63; p=0.04) and 2.68 (95% CI: 1.45, 4.98; p=0.002), respectively. After multivariable adjustment, a SL-ECG recording suspicious of AF remained a significant predictor of death or hospitalization for CV causes. Figure 1 Conclusions Pharmacy-based, automated, one-minute SL-ECG screening in elderly citizens identified subjects with unknown AF and an excess mortality risk over the next one year. Acknowledgement/Funding Unrestricted research grant by Pfizer/BMS. Matthias Zink received a DGK electrophysiology grant (funded by St. Jude Medical).</description><issn>0195-668X</issn><issn>1522-9645</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><recordid>eNqN0M1KAzEYheEgCtbqJQi5gbT5mfzMUkqtQkGhLtwNmeQbm5LOlCSzqFdvS8W1q7N6zuJF6JHRGaO1mMOYtmBT2c1h-60rNWNMiCs0YZJzUqtKXqMJZbUkSpnPW3SX845SahRTEzS8K1mJjUsAPfFQwBXw2JYUbMRdaFOI0ZYw9Dj02OKhB7IP_VgA59B_RSARrMfLxQofEvjgSsb7IRUbQzmeCUQPKR5xHtvd6Tvfo5vOxgwPvztFm-flx-KFrN9Wr4unNXFGC-Ik04q23HipnWeG1brm2hmnWy4dlQJYJ20nOuc7rQy30ktLOXdtZaQQYork5dWlIecEXXNIYW_TsWG0OTdr_po1l2bNudnJ0YsbxsM_yQ-CSnWK</recordid><startdate>20191001</startdate><enddate>20191001</enddate><creator>Zink, M D</creator><creator>Mischke, K</creator><creator>Keszei, A</creator><creator>Rummey, C</creator><creator>Freedman, B</creator><creator>Neumann, G</creator><creator>Tolksdorf, A</creator><creator>Frank, F</creator><creator>Wienstroer, J</creator><creator>Kuth, N</creator><creator>Schulz, J B</creator><creator>Marx, N</creator><general>Oxford University Press</general><scope>AAYXX</scope><scope>CITATION</scope></search><sort><creationdate>20191001</creationdate><title>P6543Screen-detected atrial fibrillation in a one-minute single-lead ECG predicts mortality in elderly subjects</title><author>Zink, M D ; Mischke, K ; Keszei, A ; Rummey, C ; Freedman, B ; Neumann, G ; Tolksdorf, A ; Frank, F ; Wienstroer, J ; Kuth, N ; Schulz, J B ; Marx, N</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c873-c51760b28d57cd18197927c8c7b25c053e1f5af3fcdf7682a5d5a022cb485333</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Zink, M D</creatorcontrib><creatorcontrib>Mischke, K</creatorcontrib><creatorcontrib>Keszei, A</creatorcontrib><creatorcontrib>Rummey, C</creatorcontrib><creatorcontrib>Freedman, B</creatorcontrib><creatorcontrib>Neumann, G</creatorcontrib><creatorcontrib>Tolksdorf, A</creatorcontrib><creatorcontrib>Frank, F</creatorcontrib><creatorcontrib>Wienstroer, J</creatorcontrib><creatorcontrib>Kuth, N</creatorcontrib><creatorcontrib>Schulz, J B</creatorcontrib><creatorcontrib>Marx, N</creatorcontrib><collection>CrossRef</collection><jtitle>European heart journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Zink, M D</au><au>Mischke, K</au><au>Keszei, A</au><au>Rummey, C</au><au>Freedman, B</au><au>Neumann, G</au><au>Tolksdorf, A</au><au>Frank, F</au><au>Wienstroer, J</au><au>Kuth, N</au><au>Schulz, J B</au><au>Marx, N</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>P6543Screen-detected atrial fibrillation in a one-minute single-lead ECG predicts mortality in elderly subjects</atitle><jtitle>European heart journal</jtitle><date>2019-10-01</date><risdate>2019</risdate><volume>40</volume><issue>Supplement_1</issue><issn>0195-668X</issn><eissn>1522-9645</eissn><abstract>Abstract Background Atrial fibrillation (AF) is the most common arrhythmia associated with increased morbidity and mortality. Current guidelines recommend opportunistic screening for AF but the prognostic impact of screen-detected AF is unclear. Methods We performed a 4-week, prospective, pharmacy-based AF screening study in 7107 elderly citizens (≥65 years) using a hand-held, automated, one-minute single-lead ECG (SL-ECG) recording device. Prevalence and incidence of AF was assessed, and data on all-cause death and hospitalization for cardiovascular (CV) causes were collected over a median follow-up of 401 (372; 435) days. Results Automated SL-ECG analyses revealed heartbeat irregularities suspicious of AF in 432 (6.1%) participants with newly diagnosed AF in 3.6% of all subjects. During follow-up, 62 participants (0.9%) died and 390 (6.0%) were hospitalised for CV causes. Total mortality was 2.3% in participants with a SL-ECG suspicious of AF and 0.8% in subjects with a normal SL-ECG (HR 2.93; 95% CI: 1.49, 5.77; P=0.002, Figure 1A); hospitalization for CV causes occurred in 10.6% and 5.5%, respectively (HR 2.08; 95% CI: 1.52, 2.84; P&lt;0.001, Figure 1B). Compared with subjects without a history of AF at baseline and a normal SL-ECG, participants with newly diagnosed AF or known AF had a significantly higher mortality risk with HRs of 2.63 (95% CI: 1.04, 6.63; p=0.04) and 2.68 (95% CI: 1.45, 4.98; p=0.002), respectively. After multivariable adjustment, a SL-ECG recording suspicious of AF remained a significant predictor of death or hospitalization for CV causes. Figure 1 Conclusions Pharmacy-based, automated, one-minute SL-ECG screening in elderly citizens identified subjects with unknown AF and an excess mortality risk over the next one year. Acknowledgement/Funding Unrestricted research grant by Pfizer/BMS. Matthias Zink received a DGK electrophysiology grant (funded by St. Jude Medical).</abstract><pub>Oxford University Press</pub><doi>10.1093/eurheartj/ehz746.1133</doi></addata></record>
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title P6543Screen-detected atrial fibrillation in a one-minute single-lead ECG predicts mortality in elderly subjects
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