Atrial Fibrillation in Geriatric Patients Identified Using Daily Rhythm Recordings

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Rhythm strips were able to identify patients with AF who were contraindicated for anticoagulation therapy.
Rhythm strips were able to identify patients with AF who were contraindicated for anticoagulation therapy.

The use of daily short-term rhythm recordings may help identify and diagnose atrial fibrillation (AF) in hospitalized geriatric patients, according to a study published in the journal Heart.1

During a 2-month period, investigators measured daily heart rhythms in geriatric patients (n=252) hospitalized at the department of geriatric medicine in Sint Jan Hospital Bruges in Belgium to evaluate the feasibility of these recordings with regard to AF identification.

In total, 1582 recordings were obtained during the 2-month period. Extensive clinical information was available in 214 patients. In addition to the identification of AF in 71 (33%) patients during routine clinical care (history, n=64 or de novo detected during hospitalization, n=7), the rhythm strips were able to identify another 28 cases (13%) of AF.

In patients with AF who were identified with the rhythm strips, all featured a CHA2DS2VASc score ≥2. In addition, approximately 25% (8 out of 28) of patients with AF had a contraindication for anticoagulant therapy.

Investigators reported that their study likely underestimates AF prevalence in their hospitalized geriatric population because they only used 1-minute snapshot recordings during measurement. Considering that some patients were excluded because they were unable to manage the detection device due to mental or motor impairment, the investigators suggested that the design may need to be modified for ease of use in this population.

Daily short-term rhythm strip recordings could play a role in early disease detection and may present “significant therapeutic implications with respect to initiation of anticoagulation,” the researchers concluded. 

Reference

Tavernier R, Wolf M, Kataria V, et al. Screening for atrial fibrillation in hospitalised geriatric patients [published online September 7, 2017]. Heart doi:10.1136/heartjnl-2017-311981

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