Acronym: Kaiser Permanente Real-World Heart Monitoring Strategy Evaluation, Treatment Patterns and Heart Metrics in Atrial Fibrillation

Purpose: Evaluation of whether atrial fibrillation burden was linked to risk for ischemic stroke or other thromboembolism in patients with continuous ECG monitoring (Zio Patch, iRhythm Technologies)

Format: Retrospective, cohort

Number of Participants: 1,965

Centers: Multicenter

Inclusion Criteria: Patients with atrial fibrillation not taking anticoagulation

Primary Outcome(s): Hospitalization for arterial thromboembolism or ischemic stroke while not taking anticoagulants

Summary: Compared with the two lower tertiles of atrial fibrillation burden, patients in the highest tertile of atrial fibrillation burden were three times as likely to have a thromboembolism while not taking anticoagulants after adjusting for CHA2DS2-VASc score (adjusted HR = 3.16; 95% CI, 1.51-6.62) or ATRIA score (aHR = 3.13; 95% CI, 1.5-6.56). Similar results were seen in demographic and clinical subgroups. The burden of atrial fibrillation was a median of 4.4%. Those with a higher burden of atrial fibrillation had more cardioversion attempts and were less likely to be Hispanic or women.

Original Publication:

Go AS, et al. JAMA Cardiol. 2018;doi:10.1001/jamacardio.2018.1176.

Link to Cardiology Today Article: