Under-diagnosis

As up to 23% of people with cryptogenic strokes and TIAs show paroxysmal AF on long-term ECG monitoring, the burden imposed by AF-related stroke may be under-estimated.4 Further evidence suggesting under-diagnosis emerged in a study that implanted a cardiac monitor in 385 patients with a CHADS2 score, a previous version of the CHA2DS2-VASc scoring system for assessing stroke risk, of 3 or greater or 2 with at least one additional risk factor. Of these, 90.4% experienced non-specific symptoms that might arise from AF, including fatigue, dyspnoea and palpitations.13

The detection rate of AF lasting six or more minutes rose from 6.2% at 30 days to 29.3% at 18 months and 40.0% at 30 months (Figure 10). Moreover, at 18 months 24.2% and 12.0% of patients experienced episodes lasting at least one hour and at least six hours a day respectively. AF incidence at 18 months was similar among patients with CHADS2 scores of 2 (24.7%), 3 (32.7%) and at least 4 (31.7%).13

Incidence of undiagnosed atrial fibrillation during insertable cardiac monitoring

Figure 10. Incidence of undiagnosed atrial fibrillation during insertable cardiac monitoring (ICM).13

 

Review details for comorbidities and differential diagnosis in the next section


Other sections to further your understanding in the disease awareness section include:

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