Original articles / Online first

The effectiveness of atrial fibrillation identification using non-invasive long-term ECG monitoring system (NOMED AF TECH)

Katarzyna Mitrega, Beata Sredniawa, Adam Y. H. Sokal, Gregory Lip, Krzysztof Rewiuk, Marcin Rutkowski, Tomasz Zdrojewski, Tomasz Grodzicki, Jaroslaw Kazmierczak, Grzegorz Opolski, Zbigniew Kalarus, Witold Streb
Published online: February 28, 2023


Introduction: Although it is well known that longer ECG monitoring allows for paroxysmal silent atrial fibrillation (SAF) detection, it is still unknown how long the ECG monitoring should last to increase probability of its diagnosis.

Objectives: The aim of this paper was to analyze ECG acquisition parameters and timing to detect SAF during NOMED-AF study.

Patients and methods: The protocol assumed up to 30 days of ECG tele-monitoring of each subject in order to reveal atrial fibrillation/atrial flutter (AF/AFL) episodes lasted at least 30 seconds. SAF was defined as AF detected and confirmed by cardiologists in asymptomatic individuals. The ECG signal analysis was based on the results of 2974 (98.67%) of all participants. AF/AFL episodes were registered and confirmed by cardiologists in 515 subjects what is 75.7% of all (680 patients) in whom AF/AFL diagnosis was set.

Results: The monitoring time to detect the first SAF episode was 6 [1; 13] days. Fifty percent of patients with this type of arrhythmia were detected by 6th day [1; 13] of the monitoring, while 75% of patients at the 13th day of study. Paroxysmal AF was registered on 4th day [1; 10].

Conclusions: The ECG monitoring time to detect the first episode of SAF in at least 75% of patients at risk of this arrhythmia was 14 days. To detect de novo AF in one subject 17 persons should be monitored. To detect one patient with SAF 11 people should be monitored, and to detect one patient with de novo SAF 23 subjects.

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