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Permanent link (DOI): https://doi.org/10.7939/R3BM2X

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The Yield of External Loop Recorder Compared to Pulse Palpation and ECG Rhythm to Detect Asymptomatic Atrial Fibrillation in a Community-Based Population Open Access

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Other title
Subject/Keyword
External Loop Recorder
Paroxysmal Atrial Fibrillation
Atrial Fibrillation
Cardioembolic Stroke
Type of item
Thesis
Degree grantor
University of Alberta
Author or creator
Albilali, Abdulrazaq S.
Supervisor and department
Shuaib, Ashfaq (Medicine)
Examining committee member and department
Khan, Khurshid (Medicine)
Buck, Brian (Medicine)
Jeerakathil, Thomas (Medicine)
Madsen, Karen (Medicine)
Department
Department of Medicine
Specialization
Experimental Medicine
Date accepted
2014-09-26T13:45:04Z
Graduation date
2014-11
Degree
Master of Science
Degree level
Master's
Abstract
Abstract Background and Purpose: Atrial fibrillation (AF) is one of the most common cardiac arrhythmia in the general population, and the most frequent source of cardiac emboli in patients with ischemic stroke.! The majority of AF events are underdiagnosed, as they are often asymptomatic or intermittent, and may not be detected by standard 12-lead electrocardiogram (ECG) or Holter monitor.! We have evaluated the diagnostic yield of a 21-day External-Loop Recorder (ELR) to detect AF events compared to pulse palpation and baseline ECG rhythm.!! Methods:!We enrolled 48 participants, 65 years of age or older with no history of atrial fibrillation, stroke or transient ischemic attack from three retirement/assisted facilities and one community clinic in Edmonton. The primary outcome was to detect any AF event (≥ 3 seconds) during the monitoring period. Results: The median ELR monitoring duration was 19 days (range 1-22 days) resulting in an AF detection rate of 27% (13/48), of which 77% (10/13) were < 30 seconds. Paroxysmal atrial tachycardia (PAT) was detected in 50% (24/48) of the participants. Pulse palpation was irregular in 3 participants and only 15% (2/13) of the participants with positive ELR results had irregular pulse palpation (p = 0.01). ECG baseline rhythm detected non-sinus rhythm in 6 participants, of which only 3 (50%) had AF events detected by the ELR. Conclusion: There is a significantly high rate of asymptomatic AF (mostly < 30 seconds) detected by the ELR compared to pulse palpation in the community population. The use of external loop recorders to evaluate for AF or PAF may be considered in patients at high risk for stroke.!
Language
English
DOI
doi:10.7939/R3BM2X
Rights
Permission is hereby granted to the University of Alberta Libraries to reproduce single copies of this thesis and to lend or sell such copies for private, scholarly or scientific research purposes only. Where the thesis is converted to, or otherwise made available in digital form, the University of Alberta will advise potential users of the thesis of these terms. The author reserves all other publication and other rights in association with the copyright in the thesis and, except as herein before provided, neither the thesis nor any substantial portion thereof may be printed or otherwise reproduced in any material form whatsoever without the author's prior written permission.
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