by Angelika Leute, Kompetenznetz Vorhofflimmern e.V. (AFNET)
Credit score: Unsplash/CC0 Public Area
An evaluation of patient-operated ECGs from the EAST—AFNET 4 trial revealed: A low AF burden beneath 6% within the first yr of early rhythm management remedy was related to low cardiovascular occasion charges in the course of the subsequent 4 years of follow-up. Sufferers with a better AF burden on early rhythm management suffered extra AF-related occasions. The findings have been offered by AFNET board member Prof. Ulrich Schotten, Maastricht College, in a hotline session on the annual congress of the European Society of Cardiology (ESC) in Madrid.
Atrial fibrillation (AF) is a typical arrhythmia resulting in extreme issues together with stroke, coronary heart failure and cardiovascular demise. Presently AF is recognized by ECG, making a lifelong, binary prognosis based mostly on presence of a single ECG exhibiting AF. Latest information illustrated the shortcomings of this binary prognosis and counsel that AF burden as a quantitative parameter, outlined because the time spent in AF per monitored time, higher displays illness severity and modulates the chance of stroke and different cardiovascular occasions.
Prof. Schotten defined, “Intermittent monitoring using patient-operated ECGs or wearables enables estimates of AF burden that could refine the diagnosis and enable individualized therapy. If AF burden estimated by patient-operated ECGs were related to cardiovascular outcomes, this would invite their use for remote, digital patient management. To investigate this question, we analyzed ECG data from the EAST—AFNET 4 trial.”
The EAST—AFNET 4 (Early Therapy of Atrial Fibrillation for Stroke Prevention) trial demonstrated that early rhythm management—with antiarrhythmic medicine or atrial fibrillation ablation—delivered inside one yr after AF prognosis improves outcomes in comparison with regular care (UC) over a 5-year follow-up time. A sequence of sub-analyses of the EAST—AFNET 4 information set verified the outcomes for various sub-groups (6–17).
Within the current evaluation, AF burden was estimated utilizing artificial-intelligence-based rhythm classification of patient-operated telemetric ECGs in sufferers randomized to early rhythm management within the EAST—AFNET 4 trial.
1,178 sufferers (70 years, 47% girls, CHA2DS2-VA 2·8±1·2) transmitted 303,308 ECGs over 5.1 years. The median AF burden was 6% within the first yr of follow-up. AF burden beneath the median was related to low charges of cardiovascular demise, stroke, or unplanned hospitalization for coronary heart failure or acute coronary syndrome. An AF burden above the median was related to increased occasion charges, corresponding to occasions with regular care.
Prof. Schotten concluded, “Our findings suggest that AF burden, estimated from patient-operated ECGs, is linked to AF-related events on rhythm control therapy. They call for further exploration of the role of AF burden and AF burden reduction for personalized rhythm-control therapy in patients with AF.”
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Affected person-operated ECGs reveal AF burden predicts long-term outcomes throughout early rhythm management (2025, September 1)
retrieved 2 September 2025
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