Arrhythmias & electrophysiologyResearch article
Impact of atrial fibrillation burden on quality of life and prediction of health care utilization: Primary results from the DEFINE AFib study
- study designed to develop and evaluate novel algorithms using ICM data
- train and test approach (70%/30%)
- multivariable logistic regression
Authors' conclusion
DEFINE AFib transformed ICM diagnostic data to predict risk of AFCA with good discrimination, particularly compared with wearable data. These results highlight the potential advantages of ICM-based continuous monitoring for AF management and the utility of ICM prediction models that could help inform pre-emptive therapeutic strategies.
Study context
- Population
- Patients with an ICM (Reveal LINQ/LINQ II; Medtronic) and a history of atrial fibrillation (AF)patients meeting inclusion criteria, 8963 30-day evaluation windows including 151 AFCAs
- Participants
- 864 patients
- Comparison
- ICM features in the last 30 days associated with first occurrence of AFCA in the next 30 days
Main finding
As reported in the abstract
AFCA prediction model discrimination (AUC)
AUC (train)
76%
AUC (test)
70%
Further findings
AFCA at the patient level, high- vs low-risk · mean time of 195 ± 164 days
| Outcome | P value |
|---|---|
| High-risk signal before AFCAs, ICM model vs AW IRN (subanalysis with smart watch data, n = 53) | P = 0.005 |
- AFCA at the patient level, high- vs low-risk — AUC
- 65%
- High-risk signal before AFCAs, ICM model vs Apple Watch (AW) irregular rhythm notification (IRN) (subanalysis with smart watch data, n = 53): ICM model 85% · AUC 57%
- High-risk signal before AFCAs, ICM model vs AW IRN (subanalysis with smart watch data, n = 53): AW IRN 23% · AUC 55%
Quality of life by daily mean AF burden (<6 minutes reference)
- 6 minutes to 5.5 hours, AFEQT
- −7.69; P < .001
- 5.5-12 hours, AFETQ
- −13.97, P < .001
- ≥5.5 hours EQ-5D
- −0.03, P = .007
- Increasing daily mean AF burden was associated with lower quality of life
Original publication
Impact of atrial fibrillation burden on quality of life and prediction of health care utilization: Primary results from the DEFINE AFib study. Heart Rhythm. Published 25 February 2026. doi:10.1016/j.hrthm.2026.02.024
Summarised from the published abstract; every number is checked against it