Arrhythmias & electrophysiology

Atrial Fibrillation Screening According to Genetic Risk: A Secondary Analysis of the Randomized LOOP Study

J Am Coll CardiolPublished Secondary analysis of the LOOP randomised trial

Authors' conclusion

ILR screening for AF was associated with a significant reduction in stroke/SE in individuals with higher genetic risk of AF but not in those with lower genetic risk.

Study context

Population
Atrial fibrillation (AF)-naive individuals aged ≥70 years with stroke risk factors and available genetic datarandomized 1:3
Participants
5,656 individuals
Comparison
Implantable loop recorder (ILR) screening vs usual care, by polygenic risk score for AF
Primary endpoint
Stroke or systemic embolism
Methodological detailsprespecified post hoc analysis
  • Prespecified post hoc analysis

Primary result

As reported in the abstract

Stroke/SE by PRSAF · median follow-up 5.4 years
ILR vs Usual careHazard ratio (95% CI)P value
PRSAF ≥median
0.65(0.43–0.97)
P = 0.036
PRSAF <median
1.06(0.72–1.57)
P = 0.75

Further findings

OutcomeEstimateP value
AF diagnosis by PRSAFHR 1.20 (95% CI 1.13–1.28)P < 0.001
≥1 AF episode lasting ≥24 hours (ILR-detected AF)OR 1.35 (95% CI 1.02–1.78)P = 0.037
  • AF diagnosis by PRS for AF (PRSAF): 969 participants (17.1%) received a diagnosis of AF

Safety

OutcomeHR (95% CI)P value
Major bleeding by PRSAFPRSAF <median1.71 (1.12–2.64)P = 0.011
  • Major bleeding by PRSAF: Pinteraction = 0.036
  • Major bleeding by PRSAF: 206 (3.6%) had major bleeding

Original publication

Atrial Fibrillation Screening According to Genetic Risk: A Secondary Analysis of the Randomized LOOP Study. J Am Coll Cardiol. Published 29 October 2025. doi:10.1016/j.jacc.2025.09.024

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