Aguinaga Luis, Bernal Walter, Bravo Alejandro, Weiss Raúl, Pilon Leonardo, Reyes Gabriela, Pozzer Domingo, Polti Alejandro, Ortigoza Daniel, Tapia Verónica, Naput Paola, Guardiet Sofía, Blanco Sergio, Labadet Carlos, Retyk Enrique, Keegan Roberto
Centro Internacional de Arritmias, Tucuman, Argentina.
Mount Sinai Hospital, Miami, Florida.
Heart Rhythm O2. 2025 May 14;6(8):1212-1217. doi: 10.1016/j.hroo.2025.05.007. eCollection 2025 Aug.
Patient characteristics and outcomes of newly diagnosed atrial fibrillation (AF) have been investigated in large registries.
The study aimed to address the role of non-invasive screening tools in diagnosing AF in the Argentinian clinical practice.
This was an observational retrospective study. Patients' clinical characteristics and management of newly diagnosed AF detected by a non-invasive screening tool were analyzed.
Of 12,635 AF outpatients, 1018/5947 (17.1%) of newly diagnosed AF were detected by a screening method: electrocardiography monitoring device (82.3%), self-pulse palpation (17.3%), and smartwatch/smartphone (0.4%).Screening (+) patients were older (73 years [63-81] vs 72 [65-81], = not significant) and had a higher prevalence of ≥ 75 year-old patients (45.5% vs 37.9%, < .001) and women (42.5% vs 41.2%, = not significant).Adjusted results (odds ratio [95% confidence interval]) by multivariate analysis showed that alcohol consumption (1.74 [1.14-2.65]), thyroid dysfunction (1.26 [1.07-1.49]), coronary artery disease (1.40 [1.19-1.64]), paroxysmal AF (2.39 [1.94-2.96]), asymptomatic condition (2.44 [2.07-2.86]), high risk of thromboembolic and bleeding complications (CHADS-Vasc, 1.18 [1.06-1.32] and HASBLED, 1.25 [1.08-1.46]), and heart failure (1.23 [1.01-1.49]) were associated with screening (+) patients. Although no difference in the oral anticoagulation therapy was detected, vitamin K antagonists were less frequently prescribed (0.66 [0.53-0.82]). Electrical cardioversion was preferred over class I and III antiarrhythmic drugs (1.33 [1.07-1.66] vs 0.61 [0.44-0.84] and 0.79 [0.64-0.97]).
Non-invasive screening tools are mainly used in Argentinian clinical practice to detect AF in asymptomatic patients at high risk of thromboembolic and bleeding complications. Vitamin K antagonists are less prescribed, and electrical cardioversion is preferred over antiarrhythmic drugs for initial rhythm control.
大型登记研究已对新诊断房颤（AF）的患者特征和结局进行了调查。
本研究旨在探讨非侵入性筛查工具在阿根廷临床实践中诊断房颤的作用。
这是一项观察性回顾性研究。分析了通过非侵入性筛查工具检测出的新诊断房颤患者的临床特征和治疗情况。
在12635例房颤门诊患者中，1018/5947例（17.1%）新诊断房颤是通过筛查方法检测出来的：心电图监测设备（82.3%）、自我脉搏触诊（17.3%）和智能手表/智能手机（0.4%）。筛查阳性患者年龄更大（73岁[63 - 81]对72岁[65 - 81]，差异无统计学意义），≥75岁患者的患病率更高（45.5%对37.9%，P <.001），女性患病率也更高（42.5%对41.2%，差异无统计学意义）。多因素分析的校正结果（比值比[95%置信区间]）显示，饮酒（1.74[1.14 - 2.65]）、甲状腺功能障碍（1.26[1.07 - 1.49]）、冠状动脉疾病（1.40[1.19 - 1.64]）、阵发性房颤（2.39[1.94 - 2.96]）、无症状状态（2.44[2.07 - 2.86]）、血栓栓塞和出血并发症的高风险（CHADS - Vasc，1.18[1.06 - 1.32]和HASBLED，1.25[1.08 - 1.46]）以及心力衰竭（1.23[1.01 - 1.49]）与筛查阳性患者相关。虽然在口服抗凝治疗方面未检测到差异，但维生素K拮抗剂的处方频率较低（0.66[0.53 - 0.82]）。与I类和III类抗心律失常药物相比，电复律更受青睐（1.33[1.07 - 1.66]对0.61[0.44 - 0.84]和0.79[0.64 - 0.97]）。
在阿根廷临床实践中，非侵入性筛查工具主要用于检测有血栓栓塞和出血并发症高风险的无症状房颤患者。维生素K拮抗剂的处方较少，对于初始心律控制，电复律比抗心律失常药物更受青睐。
