Conclusion Patients with an AHRE burden over 6 min have an increased risk for stroke .
Aims Atrial fibrillation ( AF ) patients have increased risk of stroke .
In paroxysmal AF , the combination of duration and frequency of episodes defines AF burden .
In patients with cardiac implantable electronic devices ( CIEDs ) , atrial high-rate episodes ( AHREs ) can be monitored continuously and are considered as a proxy for AF .
This systematic review aims to determine the relationship between AF burden and risk of thrombo-embolic events ( TBEs ) .
Performance of a New Leadless Implantable Cardiac Monitor in Detecting and Quantifying Atrial Fibrillation Results of the XPECT Trial
Background —Current methods for detecting atrial fibrillation ( AF ) have limited diagnostic yield . Continuous monitoring with automatic arrhythmia detection and classification may improve detection of symptomatic and asymptomatic AF and subsequent patient treatment . The study purpose was to quantify the performance of the first implantable leadless cardiac monitor ( ICM ) with dedicated AF detection capabilities . Methods and Results — Patients ( n=247 ) with an implanted ICM ( Reveal XT , Medtronic Inc , Minneapolis , Minn ) who were likely to present with paroxysmal AF were selected . A special Holter device stored 46 hours of subcutaneously recorded ECG , ICM markers , and 2 surface ECG leads . The ICM  automatic arrhythmia classification was compared with the core laboratory classification of the surface ECG . Of the 206 analyzable Holter recordings collected , 76 ( 37 % ) contained at least 1 episode of core laboratory classified AF . The sensitivity , specificity , positive predictive value , and negative predictive value for identifying patients with any AF were 96.1 % , 85.4 % , 79.3 % , and 97.4 % , respectively . The AF burden measured with the ICM was very well correlated with the reference value derived from the Holter ( Pearson coefficient=0.97 ) . The overall accuracy of the ICM for detecting AF was 98.5 % . Conclusions —In this ICM validation study , the dedicated AF detection algorithm reliably detected the presence or absence of AF and the AF burden was accurately quantified . The ICM is a promising new diagnostic and monitoring tool for the clinician to treat AF patients independently of symptoms . Long-term studies are needed to evaluate the clinical benefits of the technology . Clinical Trial Registration — clinical trials.gov Identifier NCT00680927
Conclusion Patients with an AHRE burden over 6 min have an increased risk for stroke .
Aims Atrial fibrillation ( AF ) patients have increased risk of stroke .
In paroxysmal AF , the combination of duration and frequency of episodes defines AF burden .
In patients with cardiac implantable electronic devices ( CIEDs ) , atrial high-rate episodes ( AHREs ) can be monitored continuously and are considered as a proxy for AF .
This systematic review aims to determine the relationship between AF burden and risk of thrombo-embolic events ( TBEs ) .