Holter monitoring to detect silent atrial fibrillation in high-risk subjects: the Perugia General Practitioner Study

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• 作者：Valentina Salvatori ; Cecilia Becattini ; Stefano Laureti…
• 关键词：Atrial fibrillation ; Holter monitoring ; Silent atrial fibrillation ; Excessive supraventricular ectopic activity
• 刊名：Internal and Emergency Medicine
• 出版年：2015
• 出版时间：August 2015
• 年：2015
• 卷：10
• 期：5
• 页码：595-601
• 全文大小：389 KB
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• 作者单位：Valentina Salvatori (1)
  Cecilia Becattini (1)
  Stefano Laureti (2)
  Gregorio Baglioni (2)
  Fabrizio Germini (2)
  Piero Grilli (2)
  Francesco Guercini (1)
  Esmeralda Filippucci (1)
  Giancarlo Agnelli (1)
  
  1. Internal and Cardiovascular Medicine-Stroke Unit, University of Perugia, Perugia, Italy
  2. Società Italiana Medicina Generale, Perugia, Italy
  
• 刊物主题：Internal Medicine;
• 出版者：Springer Milan
• ISSN：1970-9366

文摘

Atrial fibrillation (AF) is diagnosed for the first time in about 5?% of patients admitted for acute ischemic stroke. Advanced aged and arterial hypertension are risk factors for AF. We evaluated the prevalence of silent AF in subjects with advanced age and systemic arterial hypertension. Subjects of both gender, aged 65?years or more with systemic arterial hypertension were randomly identified from the patient lists of the participating general practitioners in the Perugia area, in Italy. Study subjects underwent baseline 12-lead ECG and, if this did not show AF, 48-h Holter monitoring was performed. AF was known and confirmed by 12-lead ECG in 4 out of the 308 evaluated subjects (1.3?%). Baseline 12-lead ECG showed no cases of silent AF. Holter monitoring was performed in 300 subjects, mean age 70?±?4. Twenty-six recordings were not evaluable for the presence of artifacts; therefore, 274 subjects were included in the analysis. Holter monitoring showed AF in 27 out of 274 subjects (10?%; 95?% confidence interval 6.4-3.5?%); AF was longer than 30?s in four of the subjects. In 56 additional subjects, Holter monitoring revealed excessive supraventricular ectopic activity (20?%; 95?% confidence interval 15.3-4.7?%). Holter monitoring was able to detect silent AF in about 10?% of subjects aged 65 or above with systemic arterial hypertension. The risk of stroke associated with screened silent AF should be carefully evaluated.