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62/100

✓ Peer-reviewed alzhub usefulness score 62 out of 100. Cognitive tests and assessment

Topic: Drug trials: efficacy and safety

Atrial fibrillation (AF) is the most common clinical arrhythmia with substantial health and socioeconomic impact on healthcare.1 The number of people affected by this condition was estimated to be 33.5 million in 2010, with an increasing prevalence and incidence over the coming years.2 In 2017, there were 37.6 million [95% confidence interval (CI): 32.5–42.6 million] individuals with AF/atrial flutter globally.3 The estimated number of subjects with AF in 2030 in Europe will be 14–17 million, and the number of new cases of AF per year at 120 000–215 000.4 Atrial fibrillation is independently associated with increased mortality and morbidity from complications such as ischaemic stroke, dementia, and cognitive dysfunction.5 Oral anticoagulation can significantly reduce the risk of stroke, dementia, and death.6 As a part of a holistic or integrated approach to AF care, it is associated with improved outcomes7–9 and is advocated in guidelines.10,11 In many patients, AF can be asymptomatic, and the diagnosis is established after the appearance of a complication typically associated with AF, such as ischaemic stroke/systemic embolic or heart failure. For example, the Event Monitoring Belt for Recording Atrial Fibrillation After a Cerebral Ischemic Event (EMBRACE) study showed that in patients after transient ischaemic attack (TIA) or cryptogenic stroke without known AF, 30 days of non-invasive event-triggered ambulatory electrocardiogram (ECG) monitoring allowed us to diagnose this arrhythmia in 16.1% of 280 individuals. At the same time, standard 24 h ECG revealed AF in only 3.2% of 277 patients.12 In individuals with stroke risk factors, implantable loop recorder (ILR) screening in the Implantable Loop recorder detection of atrial fibrillation to prevent stroke (LOOP) study resulted in a three-fold increase in AF detection and anticoagulation initiation.13 Hence, looking harder and longer with more sophisticated methods increases AF detection. Early diagnosis of AF in some high-risk populations, together with appropriate antithrombotic therapy, could potentially prevent a substantial number of strokes and mortality.14,15 Additionally, it was shown by the results of the Early Rhythm-Control Therapy in Patients with Atrial Fibrillation (EAST) study that early AF detection and effective implementation of rhythm control strategies would reduce both deaths and hospitalizations. The PPG signals registered by certified medical devices validated to the gold standard,

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APA 7th

Kalarus, Z. F., Mairesse, G. H., Sokal, A., Boriani, G., Średniawa, B., Casado-Arroyo, R., et al. (2022). Searching for atrial fibrillation: looking harder, looking longer, and in increasingly sophisticated ways. An EHRA position paper. EP Europace. https://doi.org/10.1093/europace/euac144

Vancouver

Kalarus ZF, Mairesse GH, Sokal A, Boriani G, Średniawa B, Casado-Arroyo R, et al. Searching for atrial fibrillation: looking harder, looking longer, and in increasingly sophisticated ways. An EHRA position paper. EP Europace. 2022. doi:10.1093/europace/euac144. PMID: 36256580.

BibTeX

@article{kalarus2022-36256580,
  author  = {Kalarus, Zbigniew F. and Mairesse, Georges H. and Sokal, Adam and Boriani, Giuseppe and Średniawa, Beata and Casado-Arroyo, Rubén and Wachter, Rolf and Frommeyer, Gerrit and others},
  title   = {{Searching for atrial fibrillation: looking harder, looking longer, and in increasingly sophisticated ways. An EHRA position paper}},
  journal = {EP Europace},
  year    = {2022},
  doi     = {10.1093/europace/euac144},
  pmid    = {36256580},
  url     = {https://doi.org/10.1093/europace/euac144}
}

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Key findings

Atrial fibrillation (AF) is the most common clinical arrhythmia with substantial health and socioeconomic impact on healthcare.1 The number of people affected by this condition was estimated to be 33.5 million in 2010, with an increasing prevalence and incidence over the coming years.2 In 2017, there were 37.6 million [95% confidence interval (CI): 32.5–42.6 million] individuals with AF/atrial flutter globally.3 The estimated number of subjects with AF in 2030 in Europe will be 14–17 million, and the number of new cases of AF per year at 120 000–215 000.4 Atrial fibrillation is independently associated with increased mortality and morbidity from complications such as ischaemic stroke, dementia, and cognitive dysfunction.5 Oral anticoagulation can significantly reduce the risk of stroke, dementia, and death.6 As a part of a holistic or integrated approach to AF care, it is associated with improved outcomes7–9 and is advocated in guidelines.10,11 In many patients, AF can be asymptomatic, and the diagnosis is established after the appearance of a complication typically associated with AF, such as ischaemic stroke/systemic embolic or heart failure.
For example, the Event Monitoring Belt for Recording Atrial Fibrillation After a Cerebral Ischemic Event (EMBRACE) study showed that in patients after transient ischaemic attack (TIA) or cryptogenic stroke without known AF, 30 days of non-invasive event-triggered ambulatory electrocardiogram (ECG) monitoring allowed us to diagnose this arrhythmia in 16.1% of 280 individuals.
At the same time, standard 24 h ECG revealed AF in only 3.2% of 277 patients.12 In individuals with stroke risk factors, implantable loop recorder (ILR) screening in the Implantable Loop recorder detection of atrial fibrillation to prevent stroke (LOOP) study resulted in a three-fold increase in AF detection and anticoagulation initiation.13 Hence, looking harder and longer with more sophisticated methods increases AF detection.
Early diagnosis of AF in some high-risk populations, together with appropriate antithrombotic therapy, could potentially prevent a substantial number of strokes and mortality.14,15 Additionally, it was shown by the results of the Early Rhythm-Control Therapy in Patients with Atrial Fibrillation (EAST) study that early AF detection and effective implementation of rhythm control strategies would reduce both deaths and hospitalizations.
The PPG signals registered by certified medical devices validated to the gold standard, as is ECG, could be considered comparable with the ECG due to their high sensitivity and specificity.8,9 The currently ongoing ‘Fitbit Heart Study’ is a significant clinical study designed to examine the validity of a novel PPG-based software algorithm for detecting AF.19 Nonetheless, we need to be sure of AF in an individual patient.

Study details

Participants280
Effect size16.1%; 3.2%
Evidence strengthHigh

How this study scored 62/100

Published in a peer-reviewed journal. Scored zero for study design and randomised / blinded because the record does not state it. We have no data on journal's citation record, times cited, citations per year, impact for its field and year, cited by studies here, still being cited, senior author's track record, institution's track record and multi-centre collaboration, so those were left out: it earned 36 of the 58 points we could judge it on, which is 62 out of 100.

Component	Points	Why
Journal tier	7 / 10	Tier 3 — peer-reviewed journal (EP Europace)
Journal's citation record	— / 4	No journal record from OpenAlex — left out of this score
Study design	0 / 12	No study design recorded — scores zero, not guessed (not stated in the record — scored 0)
Strength of evidence	5 / 5	Rated “high” in our summary
Peer-review validation	10 / 10	Peer-reviewed. Published as an article in a named peer-reviewed journal.
How recent	3 / 5	2022 — within 6 year(s) of the newest study here
Sample size	2 / 4	280 participants
Effect reported	2 / 3	Effect reported as a number, without an interval or test
Studied in people	3 / 3	Studied in people (participant count stated)
Randomised / blinded	0 / 2	No randomisation or blinding stated — scores zero (not stated in the record — scored 0)
Times cited	— / 7	No citation count (not found in OpenAlex) — left out of this score
Citations per year	— / 5	No citation count or no year — left out of this score
Impact for its field and year	— / 6	No field-weighted citation impact (OpenAlex has none yet) — left out of this score
Cited by studies here	— / 6	Not yet checked against this library's citation graph — left out of this score
Still being cited	— / 4	No yearly citation counts — left out of this score
Senior author's track record	— / 4	Senior author's record not available — left out of this score
Institution's track record	— / 3	No institution listed in OpenAlex — left out of this score
Multi-centre collaboration	— / 3	Institutions not listed — left out of this score
Indexed in PubMed	2 / 2	Indexed in PubMed (PMID 36256580)
Free to read	2 / 2	Free to read
Points	36 / 58	Scored on 11 of 20 parts. We have no data for the rest, so they are left out: 36 of the 58 points we could judge it on is 62 out of 100.
Total	62 / 100	—

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