Heart Rhythm O2最新文献

{"title":"High-power short-duration setting prevents changes of periprocedural thrombotic markers and the onset of silent stroke in patients with atrial fibrillation","authors":"Masashi Kamioka MD,&nbsp;Tomonori Watanabe MD,&nbsp;Hiroaki Watanabe MD,&nbsp;Takafumi Okuyama MD,&nbsp;Ayako Yokota MD,&nbsp;Takahiro Komori MD,&nbsp;Tomoyuki Kabutoya MD,&nbsp;Yasushi Imai MD,&nbsp;Kazuomi Kario MD, PhD","doi":"10.1016/j.hroo.2024.09.019","DOIUrl":"10.1016/j.hroo.2024.09.019","url":null,"abstract":"<div><h3>Background</h3><div>It remains unclear whether the newly adopted high-power, short-duration (HP-SD) setting in ablation for atrial fibrillation (AF) impacts periprocedural thrombotic markers or silent stroke (SS) onset.</div></div><div><h3>Objective</h3><div>The aim of the present study was to investigate the clinical impact of HP-SD setting ablation on changes in periprocedural thrombotic markers and the onset of SS.</div></div><div><h3>Methods</h3><div>We enrolled 101 AF patients: the HP-SD group (n = 67) using 50 W and the conventional ablation group (n = 34) using 30 to 40 W. D-dimer, thrombin-antithrombin complex (TAT), and total plasminogen activator inhibitor-1 (tPAI-1) were analyzed the day before, immediately after, and 1 day after the procedure. Magnetic resonance imaging was performed within 48 hours after the procedure.</div></div><div><h3>Results</h3><div>Left atrial dwelling time was significantly shorter in the HP-SD group (<em>P &lt;</em> .05). In the conventional ablation group, the D-dimer and tPAI-1 levels continued to increase until 1 day postprocedure, while the TAT peaked immediately after the ablation. On the other hand, the range of the variation of these thrombotic markers in the HP-SD group was smaller. SS occurred more frequently in the conventional ablation group than in the HP-SD group (26% vs 5%, <em>P &lt;</em> .05). In the logistic regression analysis, the HP-SD setting and TAT difference (postprocedure – preprocedure) were independent predictors for SS (odds ratios 0.141 and 5.838, respectively; <em>P &lt;</em> .05).</div></div><div><h3>Conclusions</h3><div>The HP-SD setting led to a shorter left atrial dwelling time and reduced change in thrombotic markers, resulting in lower prevalence of SS.</div></div>","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"5 12","pages":"Pages 917-924"},"PeriodicalIF":2.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11721730/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142972294","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of body mass index on in-hospital outcomes in patients receiving leadless pacemakers: A five-category analysis","authors":"Rajveer Sagoo BS ,&nbsp;Navraj S. Sagoo MD ,&nbsp;Ali S. Haider BS ,&nbsp;Mohanakrishnan Sathyamoorthy MD","doi":"10.1016/j.hroo.2024.09.017","DOIUrl":"10.1016/j.hroo.2024.09.017","url":null,"abstract":"<div><h3>Background</h3><div>The adoption of leadless pacemakers (LPMs) is increasing, yet the impact of body mass index (BMI) on procedural outcomes remains underexplored.</div></div><div><h3>Objective</h3><div>The purpose of this study was to explore the impact of BMI on in-hospital outcomes for patients receiving LPM implantation.</div></div><div><h3>Methods</h3><div>Data from the National Inpatient Sample from 2018–2021 were analyzed for patients older than 18 years who underwent LPM implantation, with specific inclusion and exclusion criteria applied. Patients were identified using <em>International Classification of Diseases 10th Revision</em> codes and categorized into BMI groups: underweight, normal, overweight, obese, and morbidly obese. The primary outcome assessed was in-hospital mortality. Secondary outcomes included blood transfusion, pericardial complications, infection/inflammation, removal/revision, and other complications.</div></div><div><h3>Results</h3><div>The study included 3832 patients who underwent LPM implantation between 2018 and 2021, weighted to represent 19,610 patients, with 3540 having an appropriate BMI designation. Mortality was lower in the obese group (2.3%) compared to the nonobese group (2.7%) (adjusted odds ratio [aOR] 0.462, 95% confidence interval [CI] 0.259–0.623, <em>P</em> = .009). Compared to the normal weight group, those categorized as overweight, obese, and morbidly obese demonstrated a lower risk of in-hospital mortality (aOR 0.432, 95% CI 0.299–0.734, <em>P</em> = .009; aOR 0.465, 95% CI 0.238–0.721, <em>P</em> &lt;.001; aOR 0.299, 95% CI 0.153–0.586, <em>P</em> &lt;.001, respectively).</div></div><div><h3>Conclusion</h3><div>These findings support the existence of the obesity paradox in patients with LPM implantation, where higher BMI categories are associated with improved mortality outcomes, meeting our prespecified primary endpoint. Further studies are needed to clarify the mechanisms behind these observations.</div></div>","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"5 12","pages":"Pages 883-889"},"PeriodicalIF":2.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11721722/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142972295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"VO-03 EFFICACY OF CATHETER ABLATION OF FREQUENT ASYMPTOMATIC IDIOPATHIC PREMATURE VENTRICULAR COMPLEXES IN TREATING LATENT LEFT VENTRICULAR SYSTOLIC DYSFUNCTION AS ASSESSED BY SPECKLE TRACKING OF LEFT VENTRICULAR GLOBAL LONGITUDINAL STRAIN","authors":"Hesham Tarek,&nbsp;Hayam El Damanhoury,&nbsp;Mohammed Moussa,&nbsp;Ahmed Gamal El Din,&nbsp;Haitham Badran,&nbsp;John Kamel Zarif","doi":"10.1016/j.hroo.2024.10.014","DOIUrl":"10.1016/j.hroo.2024.10.014","url":null,"abstract":"","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"5 12","pages":"Pages S3-S4"},"PeriodicalIF":2.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143180954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation, bias assessment, and optimization of the UNAFIED 2-year risk prediction model for undiagnosed atrial fibrillation using national electronic health data","authors":"Mohammad Ateya PharmD, MS ,&nbsp;Danai Aristeridou MSc ,&nbsp;George H. Sands MD ,&nbsp;Jessica Zielinski BS ,&nbsp;Randall W. Grout MD, MS ,&nbsp;A. Carmine Colavecchia PharmD, PhD ,&nbsp;Oussama Wazni MD, FHRS ,&nbsp;Saira N. Haque PhD, MHSA","doi":"10.1016/j.hroo.2024.09.010","DOIUrl":"10.1016/j.hroo.2024.09.010","url":null,"abstract":"<div><h3>Background</h3><div>Prediction models for atrial fibrillation (AF) may enable earlier detection and guideline-directed treatment decisions. However, model bias may lead to inaccurate predictions and unintended consequences.</div></div><div><h3>Objective</h3><div>The purpose of this study was to validate, assess bias, and improve generalizability of “UNAFIED-10,” a 2-year, 10-variable predictive model of undiagnosed AF in a national data set (originally developed using the Indiana Network for Patient Care regional data).</div></div><div><h3>Methods</h3><div>UNAFIED-10 was validated and optimized using Optum de-identified electronic health record data set. AF diagnoses were recorded in the January 2018–December 2019 period (outcome period), with January 2016–December 2017 as the baseline period. Validation cohorts (patients with AF and non-AF controls, aged ≥40 years) comprised the full imbalanced and randomly sampled balanced data sets. Model performance and bias in patient subpopulations based on sex, insurance, race, and region were evaluated.</div></div><div><h3>Results</h3><div>Of the 6,058,657 eligible patients (mean age 60 ± 12 years), 4.1% (n = 246,975) had their first AF diagnosis within the outcome period. The validated UNAFIED-10 model achieved a higher C-statistic (0.85 [95% confidence interval 0.85–0.86] vs 0.81 [0.80–0.81]) and sensitivity (86% vs 74%) but lower specificity (66% vs 74%) than the original UNAFIED-10 model. During retraining and optimization, the variables insurance, shock, and albumin were excluded to address bias and improve generalizability. This generated an 8-variable model (UNAFIED-8) with consistent performance.</div></div><div><h3>Conclusion</h3><div>UNAFIED-10, developed using regional patient data, displayed consistent performance in a large national data set. UNAFIED-8 is more parsimonious and generalizable for using advanced analytics for AF detection. Future directions include validation on additional data sets.</div></div>","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"5 12","pages":"Pages 925-935"},"PeriodicalIF":2.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11721729/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142972328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk of stroke with reduced dose direct oral anticoagulants vs standard dose anticoagulation after cardioversion of atrial fibrillation: A systematic review and meta-analysis","authors":"Travis Quevillon MD ,&nbsp;Erik Slade MD ,&nbsp;Faith Michael MD ,&nbsp;Alexander P. Benz MD, MSc ,&nbsp;William F. McIntyre MD, PhD ,&nbsp;Ratika Parkash MD, MSc ,&nbsp;Jeff S. Healey MD, MSc ,&nbsp;Dennis T. Ko MD, MSc ,&nbsp;Mohammed Shurrab MD, MSc, PhD","doi":"10.1016/j.hroo.2024.09.011","DOIUrl":"10.1016/j.hroo.2024.09.011","url":null,"abstract":"<div><h3>Background</h3><div>There is consensus on the safety of standard dose direct oral anticoagulants (DOACs) for stroke prevention in patients undergoing cardioversion of atrial fibrillation (AF), but outcomes of reduced dose DOACs in this setting remain unclear.</div></div><div><h3>Objective</h3><div>This systematic review and meta-analysis aimed to compare the rate of cardioversion-associated thromboembolic events between patients taking reduced dose DOACs and those receiving standard dose anticoagulation.</div></div><div><h3>Methods</h3><div>A systematic search was conducted for studies published between January 1, 2009, and February 16, 2024 in PubMed, Embase, and Cochrane Central Register of Controlled Trials. The included studies compared the rate of thromboembolic events in patients with AF undergoing cardioversion on reduced dose DOACs with the rate in those on standard dose anticoagulation. Odds ratios were pooled with a random effects model.</div></div><div><h3>Results</h3><div>We identified 2 randomized controlled trials and 8 cohort studies, which included 5212 patients with AF who underwent cardioversion on anticoagulation (1010 patients on reduced dose DOACs and 4202 patients on standard dose anticoagulation). Follow-up ranged from 3 hours to 90 days after cardioversion. There was a numerically higher rate of thromboembolic events in patients undergoing cardioversion on reduced dose DOACs than in those on standard dose anticoagulation (0.69% vs 0.29%; odds ratio 1.98; 95% confidence interval 0.72–5.45; <em>P</em> = .19; I² = 0%); however, the difference was not statistically significant.</div></div><div><h3>Conclusion</h3><div>Our systematic review and meta-analysis suggests that there is a numerically higher risk of thromboembolic events in patients with AF undergoing cardioversion on reduced dose DOACs than in those on standard dose anticoagulation. However, the difference was not statistically significant. These findings raise concern about the safety of reduced dose DOACs in patients undergoing cardioversion.</div></div>","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"5 12","pages":"Pages 942-950"},"PeriodicalIF":2.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11721732/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142972325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"VO-05 FACTORS ASSOCIATED WITH NONUPTAKE OF IMPLANTABLE CARDIOVERTER-DEFIBRILLATOR (ICD) AMONG ELIGIBLE PATIENTS AT A TERTIARY HOSPITAL IN KENYA","authors":"Emmanuel Oluoch,&nbsp;Jasmit Shah,&nbsp;Mohamed Varwani,&nbsp;Mohamed Jeilan,&nbsp;Mzee Ngunga","doi":"10.1016/j.hroo.2024.10.016","DOIUrl":"10.1016/j.hroo.2024.10.016","url":null,"abstract":"","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"5 12","pages":"Pages S4-S5"},"PeriodicalIF":2.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143179714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"VO-06 SUCCESS AND COMPLICATION RATES OF LEAD EXTRACTION AT THE NATIONAL HEART INSTITUTE","authors":"Samhaa Alsayed Hamed,&nbsp;Azza Katta,&nbsp;Mostafa Mansy,&nbsp;Mahmoud Elsherif,&nbsp;Mohamed Abou Alhassan,&nbsp;Haitham Badran,&nbsp;Ahmed Eldamaty,&nbsp;Mohamed Ossama","doi":"10.1016/j.hroo.2024.10.017","DOIUrl":"10.1016/j.hroo.2024.10.017","url":null,"abstract":"","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"5 12","pages":"Pages S5-S6"},"PeriodicalIF":2.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143180160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A proposed algorithm for management of patients with left bundle branch block post-TAVR: 1-year follow-up","authors":"Avia Bar-Moshe BsC ,&nbsp;Amjad Abu-Salman MD ,&nbsp;Einat Frumkin BsC ,&nbsp;Carlos Cafri MD ,&nbsp;Miri Merkin MD ,&nbsp;Sergiy Bereza MD ,&nbsp;Louise Kezerle MD ,&nbsp;Moti Haim MD ,&nbsp;Yuval Konstantino MD","doi":"10.1016/j.hroo.2024.09.015","DOIUrl":"10.1016/j.hroo.2024.09.015","url":null,"abstract":"<div><h3>Background</h3><div>Transcatheter aortic valve replacement (TAVR) has revolutionized the management of aortic stenosis and has become the standard of care across a broad spectrum of patients with aortic stenosis. However, it is still associated with high incidence of conduction abnormalities, particularly new left bundle branch block (LBBB). Management of these patients remains a challenge.</div></div><div><h3>Objective</h3><div>The study sought to assess the clinical outcomes of patients with post-TAVR conduction disorders managed according to a prespecified institutionally developed algorithm.</div></div><div><h3>Methods</h3><div>A retrospective analysis including all patients undergoing TAVR in our institute between October 2018 and December 2022 was performed. Patients with new LBBB were managed according to the algorithm comprising QRS width and electrophysiology study. In-hospital and 1-year clinical outcomes were assessed.</div></div><div><h3>Results</h3><div>A total of 230 patients were included in the present analysis. Seventy (30.4%) patients developed new LBBB after TAVR. Overall, 44 (19.1%) patients required permanent pacemaker (PPM) implantation: 20 (8.7%) patients with Mobitz II, complete atrioventricular block, or alternating bundle branch block; 21 (9.1%) patients with persistent new LBBB; and 3 (1.3%) patients per physician discretion. During 1-year follow-up, only 3 patients required late PPM implantation, of whom there was only 1 patient with new LBBB. There was no difference in mortality or heart failure hospitalizations between the per PPM and no PPM groups. Multivariable analysis identified atrial fibrillation, chronic kidney disease, and pre-TAVR right bundle branch block as independent predictors for PPM implantation following TAVR.</div></div><div><h3>Conclusion</h3><div>Our findings suggest that the presented algorithm may serve as a safe and efficacious strategy for management of patient with post-TAVR LBBB, although the PPM implantation rate may be further reduced.</div></div>","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"5 12","pages":"Pages 873-882"},"PeriodicalIF":2.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11721728/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142972288","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Percutaneous left atrial appendage closure using a modified single-operator-technician approach under deep sedation: A single-center experience","authors":"Alejandro José Quiroz Alfaro MD ,&nbsp;Noah E. Russell DO ,&nbsp;Ruhul Munshi MD ,&nbsp;Waleed Hassan MD ,&nbsp;James E. Stone MD ,&nbsp;Elsheikh M. Abdelrahim MD ,&nbsp;Karl J. Crossen MD ,&nbsp;Karthik Venkatesh Prasad MD","doi":"10.1016/j.hroo.2024.10.004","DOIUrl":"10.1016/j.hroo.2024.10.004","url":null,"abstract":"<div><h3>Background</h3><div>Historically, percutaneous transcatheter left atrial appendage closure (LAAC) has been performed under general anesthesia (GA) with transesophageal echocardiographic images obtained by a noninvasive cardiologist and usually requires an overnight hospital stay. Alternatively, we present our single-center experience performing LAACs under deep sedation (DS), employing an echocardiographic technician instead of a noninvasive cardiologist, and expediting same-day discharge. Mid- to long-term outcomes were also evaluated with follow-up imaging at a 45-day visit.</div></div><div><h3>Objective</h3><div>The purpose of this study was to demonstrate the safety, feasibility, and outcomes of our single-operator-technician LAAC approach.</div></div><div><h3>Methods</h3><div>A total of 150 patients, with elevated CHA₂DS₂-VASc scores (a mean of 4 points), underwent transesophageal echocardiography–guided LAAC using the WATCHMAN FLX (Boston Scientific, Marlborough, MA) device under DS.</div></div><div><h3>Results</h3><div>The mean age of patients was 78 years. Seventy-six (51%) were men. One hundred forty-seven patients (98%) had the LAAC device successfully implanted, and 145 (97%) were discharged on the same day. Nine patients (6%) required conversion from DS to GA. Only 5 patients (4%) had complications during the procedure. None of the patients died or had complications from DS. During the 45-day follow-up visit, one patient had a significant peridevice leak (maximum diameter ≥ 5 mm) and another patient had device-related thrombosis.</div></div><div><h3>Conclusion</h3><div>Our novel single-operator-technician approach under DS is safe and feasible. Implementing protocols to simplify the traditional 2-operator approach under GA by using DS and an echocardiography technician as well as incorporating same-day discharge could make LAACs more widely available and potentially reduce procedural costs.</div></div>","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"5 12","pages":"Pages 936-941"},"PeriodicalIF":2.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11721720/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142972322","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of continuous cardiac monitoring to assess the influence of atrial fibrillation burden and patterns on patient symptoms and healthcare utilization: The DEFINE AFib study","authors":"Dhanunjaya R. Lakkireddy MD ,&nbsp;Andrea M. Russo MD ,&nbsp;Elaine M. Hylek MD, MPH ,&nbsp;Suneet Mittal MD ,&nbsp;James Peacock MD, MS ,&nbsp;Mellanie True Hills ,&nbsp;Evan J. Stanelle MS, MA ,&nbsp;Jeffrey D. Lande MS, PhD ,&nbsp;Noreli C. Franco PhD ,&nbsp;Lawrence C. Johnson PhD ,&nbsp;Rahul Kanwar MS ,&nbsp;Rod S. Passman MD, MHS ,&nbsp;Jonathan P. Piccini MD, MHS","doi":"10.1016/j.hroo.2024.09.018","DOIUrl":"10.1016/j.hroo.2024.09.018","url":null,"abstract":"<div><h3>Background</h3><div>Atrial fibrillation (AF) has a significant impact on health and quality of life. The relationship of AF burden and temporal patterns of AF on patient symptoms, outcomes, and healthcare utilization is unknown. Insertable cardiac monitors (ICMs) are a strategic and as yet untapped, tool to investigate these relationships.</div></div><div><h3>Objective</h3><div>The DEFINE Atrial Fibrillation (DEFINE AFib) study will evaluate how AF burden and patterns are associated with changes in AF-related healthcare utilization (AFHCU) and patient-reported quality of life.</div></div><div><h3>Methods</h3><div>This is a prospective, observational, multicenter study with a unique design that supports a complete method of assessing AF as a multifactorial disease. Patients with AF implanted with an ICM will be enrolled in the study and managed through an app-based research platform on their smartphone. Patients will be remotely monitored and patient-reported outcomes will be collected via the app. AFHCU will be confirmed via the participant’s medical record.</div></div><div><h3>Results</h3><div>The primary analysis will evaluate whether summary and episodic measurements collected by ICMs are associated with changes in AFHCU. Secondary analyses will determine the relationship between AF characteristics and quality of life, timing and severity of AF-related complications, patient engagement, reliability of patient-reported outcomes, data from other digital rhythm detectors, and heterogeneity in care quality and AFHCU.</div></div><div><h3>Conclusion</h3><div>The DEFINE AFib study will provide valuable insights into the association between dynamic measures of AF and AFHCU in a patient population with known AF. The results may demonstrate the impact of ICM-detected AF on patient outcomes and help isolate novel AF patterns predictive of clinical risk.</div></div>","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"5 12","pages":"Pages 951-956"},"PeriodicalIF":2.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11721724/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142972327","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}