Three days of monitoring without AF episodes ≥30 seconds excludes a 14-day AF burden ≥0.1% in 97% of patients (probability 3.1%, 95% CI 2.7-3.4%).
Observational
Can monitoring time without AF predict overall 14-day AF burden in patients without permanent/persistent AF?
11,639 US patients without permanent/persistent AF, median age 62 years (IQR 46-73), 40.6% male, monitored for 14 days in 2021 with the PocketECG device.
14-day continuous ECG monitoring to model AF burden based on monitoring duration without AF episodes.
Overall 14-day AF burden modeled as a function of monitoring duration without AF episodes lasting 30 seconds to <6 minutes, 6 minutes-1 hour and >1 hour.surrogate
Three days of continuous ECG monitoring without AF episodes ≥30 seconds can reliably exclude an overall 14-day AF burden >0.1% in 97% of patients.
Background: Atrial fibrillation (AF) burden is associated with adverse outcomes; in some patients very low AF burden may not be actionable.Objective: To model AF burden as a function of monitoring time without AF.Methods: We included 11,639 US patients (median age 62 years (inter-quartile range (IQR) 46-73, 40.6% male) without permanent/persistent AF, monitored for 14 days in 2021 with the PocketECG device (MEDICALgorithmics).The overall 14-day AF burden was modelled as a function of monitoring duration without AF episodes lasting 30 seconds to <6 minutes, 6 minutes-1 hour and 1 hour.Results are presented as 95 th percentiles of AF burden.Confidence intervals (CIs) were bootstrapped with 10,000 replications.Results: AF with a median burden of 2.6% (IQR 0.00-0.13)was detected in 1,186 patients (10.4%), of whom 985 had 1 episode 6 minutes, and 769 had 1 episode 1 hour.AF burden decreased rapidly with increasing monitoring time without AF.After 3 days the 95 th percentile of AF burden was 0.00% (95%CI 0.00-0.00%) in patients without any 30 second episodes, 0.008% (95%CI 0.00-0.02%)without any 6 minute episode and 0.08% (95%CI 0.03-0.18%)without any 1 hour episodes.The probability of an AF burden 0.1% after 3 days without 30 seconds AF was 3.1% (95%CI 2.7-3.4%). J o u r n a l P r e -p r o o fConclusion: Monitoring time without AF can be used to predict 14-day AF burden, and rule out AF burdens above certain thresholds.In this unselected patient sample 3 days of monitoring without AF episodes 30 seconds excludes AF burdens 0.1% in 97% of patients.
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Linda S. Johnson
William F. McIntyre
Albin Edegran
Heart Rhythm
University of British Columbia
Karolinska Institutet
McMaster University
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Johnson et al. (Wed,) conducted a observational in Atrial fibrillation (n=11,639). PocketECG device monitoring was evaluated on 14-day AF burden as a function of monitoring duration without AF episodes. Three days of monitoring without AF episodes ≥30 seconds excludes a 14-day AF burden ≥0.1% in 97% of patients (probability 3.1%, 95% CI 2.7-3.4%).
www.synapsesocial.com/papers/69d895206c1944d70ce061e7 — DOI: https://doi.org/10.1016/j.hrthm.2026.03.1955