Arrhythmias & electrophysiology
External validation of atrial fibrillation risk scores in heart failure under continuous device surveillance
Authors' conclusion
In continuously monitored populations with AF, most population AF scores underperformed; FIND-AF performs best but remains below thresholds for stand-alone decisions.
Study context
- Population
- Outpatients with heart failure (HF) without prior atrial fibrillation (AF), with implantable loop recorders or cardiac implantable electronic devices for continuous monitoring; pre-baseline atrial high-rate episodes ≥6 min excluded
- Participants
- 396 outpatients
- Exposure
- 13 published AF risk scores
- Outcome
- Incident AF (≥6 min by device diagnostics or 12-lead ECG)
Methodological detailsexternal validation of risk scores, multicentre, continuous device monitoring
- External validation of risk scores
- Multicentre
- Continuous device monitoring
Main finding
As reported in the abstract
| Group | AUC |
|---|---|
| FIND-AF | 0.72 (95% CI 0.66-0.78) |
FIND-AF
AUC0.72 (95% CI 0.66-0.78)
- Incident AF during follow-up
- 98 (24.8%)
- Most other scores performed modestly (typical AUC)
- ≈0.50-0.61
Observational data: associations, not effects.
Further findings
Calibration
- Generally suboptimal, with risk overestimation and slopes <1; FIND-AF required recalibration (intercept and slope adjustments)
Decision curve net benefit · 5 years
- FIND-AF and MVP-ECG gave the most consistent net benefit vs treat all/none across plausible threshold probabilities; absolute gains moderate
Original publication
External validation of atrial fibrillation risk scores in heart failure under continuous device surveillance. Heart Rhythm. Published 11 December 2025. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →