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
- Other title
External Loop Recorder
Paroxysmal Atrial Fibrillation
- Type of item
- 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 of Medicine
- Date accepted
- Graduation date
Master of Science
- Degree level
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.!
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