Arrhythmias & electrophysiology
Performance of Atrial Fibrillation Burden Trends for Stroke Risk Stratification
Authors' conclusion
AF burden trends may provide incremental prognostic value as leading indicators of stroke risk compared with conventional schemes.
Study context
- Population
- Patients with an insertable cardiac monitor, Optum Clinformatics Data Mart linked with Medtronic CareLink database, 2007–2019869 ischemic strokes
- Participants
- 5,013 patients
- Exposure
- Atrial fibrillation (AF) management vs Suspected AF vs Cryptogenic stroke
- AF managementn = 1,197
- Suspected AFn = 1,611
- Cryptogenic stroken = 2,205
- Outcome
- Ischemic stroke prediction by temporal AF burden trends
Methodological detailsprognostic modelling (classification trees)
- Prognostic modelling (classification trees)
Main finding
As reported in the abstract
Predictors of ischemic stroke (variable importance)
- Prior stroke or TIA (No. 1 predictor), variable importance
- 13.13
- No prior diagnosis of AF, variable importance
- 7.35
- AF burden trends in follow-up, variable importance
- 2.59
- Baseline characteristics + AF burden trends, AUC
- 0.73
- Baseline characteristics + AF burden trends, specificity
- 0.70
- Baseline characteristics + AF burden trends, RR
- 5.00
Observational data: associations, not effects.
Further findings
| Outcome | AF management | Suspected AF | Cryptogenic stroke |
|---|---|---|---|
| Temporal proximity of AF and stroke risk by device indication (simple moving averages) | <8 days | 8-21 days | 8-21 days |
Original publication
Performance of Atrial Fibrillation Burden Trends for Stroke Risk Stratification. Circ Arrhythm Electrophysiol. Published 24 October 2024. doi:10.
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