Prospective multicentric validation of a novel prediction model for paroxysmal atrial fibrillation
Authors:
Constanze Schmidt, Sebastian Benda, Patricia Kraft, Felix Wiedmann, Sven Pleger, Antonius Büscher, Dierk Thomas, Rolf Wachter, Christian Schmid, Roland Eils, Hugo A. Katus, Stefan M. Kallenberger
The early recognition of paroxysmal atrial fibrillation (pAF) is a major clinical challenge for preventing thromboembolic events. In this prospective and multicentric study we evaluated prediction scores for the presence of pAF, calculated from non-invasive medical history and echocardiographic parameters, in patients with unknown AF status.
Methods
The 12-parameter score with parameters age, LA diameter, aortic root diameter, LV,ESD, TDI Aʹ, heart frequency, sleep apnea, hyperlipidemia, type II diabetes, smoker, ß-blocker, catheter ablation, and the 4-parameter score with parameters age, LA diameter, aortic root diameter and TDI A’ were tested. Presence of pAF was verified by continuous electrocardiogram (ECG) monitoring for up to 21 days in 305 patients.
Results
The 12-parameter score correctly predicted pAF in all 34 patients, in which pAF was newly detected by ECG monitoring. The 12- and 4-parameter scores showed sensitivities of 100% and 82% (95%-CI 65%, 93%), specificities of 75% (95%-CI 70%, 80%) and 67% (95%-CI 61%, 73%), and areas under the receiver operating characteristic (ROC) curves of 0.84 (95%-CI 0.80, 0.88) and 0.81 (95%-CI 0.74, 0.87). Furthermore, properties of AF episodes and durations of ECG monitoring necessary to detect pAF were analysed.
Conclusions
The prediction scores adequately detected pAF using variables readily available during routine cardiac assessment and echocardiography. The model scores, denoted as ECHO-AF scores, represent simple, highly sensitive and non-invasive tools for detecting pAF that can be easily implemented in the clinical practice and might serve as screening test to initiate further diagnostic investigations for validating the presence of pAF.
Graphic abstract
Prospective validation of a novel prediction model for paroxysmal atrial fibrillation based on echocardiography and medical history parameters by long-term Holter ECG
Prospective multicentric validation of a novel prediction model for paroxysmal atrial fibrillation
Authors
Constanze Schmidt Sebastian Benda Patricia Kraft Felix Wiedmann Sven Pleger Antonius Büscher Dierk Thomas Rolf Wachter Christian Schmid Roland Eils Hugo A. Katus Stefan M. Kallenberger
