Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Observational Study
. 2018 Oct;41(10):1273-1280.
doi: 10.1002/clc.23053. Epub 2018 Oct 18.

Design and rationale of the atrial fibrillation occurring transiently with stress (AFOTS) follow-up cohort study

William F McIntyre  1   2   3 , Pablo A Mendoza  2   3 , Emilie P Belley-Côté  1   2   3   4 , Richard P Whitlock  2   3   4   5 , Kevin J Um  3   6 , Natalie Maystrenko  3 , P J Devereaux  1   2   3 , David Conen  1   2   3 , Jorge A Wong  1   2   3 , Stuart J Connolly  1   2   3 , Jeff S Healey  1   2   3
Affiliations
Observational Study

Design and rationale of the atrial fibrillation occurring transiently with stress (AFOTS) follow-up cohort study

William F McIntyre et al. Clin Cardiol. 2018 Oct.

Abstract

Atrial fibrillation occurring transiently with stress (AFOTS) describes the first detection of AF in a patient who is hospitalized for a non-cardiac medical illness or following non-cardiac surgery. Uncertainty exists whether episodes of AFOTS are due to reversible precipitants and will not recur after recovery, or if they are paroxysmal atrial fibrillation (AF) that is detected during inpatient cardiac monitoring. Previous studies have used retrospective, non-systematic and ultimately low-sensitivity protocols to investigate the recurrence of AF in patients with AFOTS. The prospective, multi-center, investigator-initiated AFOTS Follow-Up Cohort Study will enroll 138 case patients with AFOTS in the setting of non-cardiac surgery or medical illness, matched 1:1 with control patients for age, sex, stressor, and hospital unit. Participants will wear a 14-day ECG heart monitor at 1 and 6 months after hospital discharge. Over 12 months of follow-up, we will collect data regarding participant's medications, and clinical events. The primary endpoint is detection of 30 or more seconds of AF after hospital discharge. To date, 50% of the target sample has been enrolled. The study is expected to complete enrolment in mid-2019 and conclude 1 year later. The AFOTS follow-up study will employ a systematic protocol to detect AF and will provide a precise and valid estimate of AF recurrence following AFOTS. This study will establish whether patients with AFOTS have an increased propensity to AF after hospitalization as compared to matched controls and may inform the management of this population.

Keywords: atrial fibrillation; electrocardiography ambulatory ECG; stroke prevention.

PubMed Disclaimer

Conflict of interest statement

The authors declare no potential conflict of interests.

Figures

Figure 1
Figure 1
Study design The study comprises of two prospective, observational cohort studies. Each cohort includes a group of 69 AFOTS patients and 69 matched controls. During enrolment, all participants will have their demographics and medical history collected. All participants will wear a 14‐day adhesive ECG monitor at 1 and 6 months after discharge and will return for a final study visit at 12‐months post enrollment. The primary endpoint of this study is detection of recurrent AF. AF, atrial fibrillation
Figure 2
Figure 2
Conceptual model of the atrial fibrillation occurring transiently with stress (AFOTS) study strengths CHF, congestive heart failure; ECG, electrocardiogram; OAC, oral anticoagulation
See this image and copyright information in PMC

References

    1. Wolf PA, Abott RD, Kannel WB. Atrial fibrillation: a major contributor to stroke in the elderly. Arch Intern Med. 1987;147:1561‐1564. - PubMed
    1. Hart RG, Pearce LA, Aguilar MI. Adjusted‐dose warfarin versus aspirin for preventing stroke in patients with atrial fibrillation. Ann Intern Med. 2007;147(8):590‐592. - PubMed
    1. January CT, Wann LS, Alpert JS, et al. 2014 AHA/ACC/HRS guideline for the management of patients with atrial fibrillation: a report of the American College of Cardiology/American Heart Association task force on practice guidelines and the Heart Rhythm Society. J Am Coll Cardiol. 2014;64(21):e1‐e76. - PubMed
    1. Kirchhof P, Benussi S, Kotecha D, et al. 2016 ESC guidelines for the management of atrial fibrillation developed in collaboration with EACTS: the task force for the management of atrial fibrillation of the European Society of Cardiology (ESC)developed with the special contribution of the European heart rhythm association (EHRA) of the ESCEndorsed by the European stroke organisation (ESO). Eur Heart J. 2016;37:2893‐2962. - PubMed
    1. Macle L, Cairns J, Leblanc K, et al. 2016 focused update of the Canadian cardiovascular society guidelines for the Management of Atrial Fibrillation. Can J Cardiol. 2016;32(10):1170‐1185. - PubMed

Publication types