HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): John R. Mehall Walter H. Merrill Randall K. Wolf Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Mehall, J. R. Articles by Wolf, R. K. Search for Related Content PubMed PubMed Citation Articles by Mehall, J. R. Articles by Wolf, R. K. Related Collections Electrophysiology - arrhythmias

Ann Thorac Surg 2007;83:2118-2121
© 2007 The Society of Thoracic Surgeons

---

Original Articles: Cardiovascular

Absence of Correlation Between Symptoms and Rhythm in "Symptomatic" Atrial Fibrillation

Section of Cardiothoracic Surgery, Department of Surgery, University of Cincinnati, Cincinnati, Ohio

Accepted for publication February 26, 2007.

^_* Address correspondence to Dr Mehall, Section of Cardiothoracic Surgery, University of Cincinnati, 231 Albert B. Sabin Way, PO Box 670558, Cincinnati, OH 45367 (Email: john.mehall{at}uc.edu).

Presented at the Poster Session of the Fifty-third Annual Meeting of the Southern Thoracic Surgical Association, Tucson, AZ, Nov 8–12, 2006.

Background: Symptoms are widely used as a means of assessment and follow-up of patients with atrial fibrillation. This study assessed the correlation between symptoms and cardiac rhythm in patients being evaluated for operative therapy for atrial fibrillation.

Methods: Seven days of preoperative continuous outpatient home electrocardiographic monitoring was performed on 50 patients with symptomatic atrial fibrillation. Cardiac rhythm was continuously monitored automatically, while patients recorded their symptoms electronically. Correlations were then drawn between symptomatic events and actual rhythm, and between atrial fibrillation episodes and symptoms.

Results: Fifty patients (37 men) with symptomatic atrial fibrillation were monitored for a combined 356 days (mean, 7.1 days). Patients were average age of 69 years old. Intermittent atrial fibrillation was reported by 36 patients, and 14 believed their atrial fibrillation was continuous. During monitoring, all patients had periods of both atrial fibrillation and normal sinus rhythm. Of the 552 documented episodes of atrial fibrillation, 467 (85%) were asymptomatic, and 85 (15%) episodes were symptomatic. Patients indicated that they experienced atrial fibrillation symptoms 163 times. Of the 163 symptomatic events, 85 (52%) were actual atrial fibrillation, 64 (42%) were sinus rhythm, and 14 (6%) were other rhythms. The ability of an individual patient to accurately identify atrial fibrillation ranged from 0% to 100%.

Conclusions: Patient-reported symptoms of atrial fibrillation had poor correlation with actual rhythm. The lack of correlation between symptoms and rhythm underscores the importance of continuous home monitoring for accurately quantifying preoperative atrial fibrillation burden and for postoperative follow-up.

This article has been cited by other articles:

				R. Beukema, W. P. Beukema, H. T. Sie, A. R. Misier, P. P. Delnoy, and A. Elvan Monitoring of atrial fibrillation burden after surgical ablation: relevancy of end-point criteria after radiofrequency ablation treatment of patients with lone atrial fibrillation Interactive CardioVascular and Thoracic Surgery, December 1, 2009; 9(6): 956 - 959. [Abstract] [Full Text] [PDF]

				T. Hanke, E. I. Charitos, U. Stierle, A. Karluss, E. Kraatz, B. Graf, A. Hagemann, M. Misfeld, and H. H. Sievers Twenty-Four-Hour Holter Monitor Follow-Up Does Not Provide Accurate Heart Rhythm Status After Surgical Atrial Fibrillation Ablation Therapy: Up to 12 Months Experience With a Novel Permanently Implantable Heart Rhythm Monitor Device Circulation, September 15, 2009; 120(11_suppl_1): S177 - S184. [Abstract] [Full Text] [PDF]

				J. R. Edgerton, J. H. McClelland, D. Duke, M. W. Gerdisch, B. M. Steinberg, S. H. Bronleewe, S. L. Prince, M. A. Herbert, S. Hoffman, and M. J. Mack Minimally invasive surgical ablation of atrial fibrillation: Six-month results J. Thorac. Cardiovasc. Surg., July 1, 2009; 138(1): 109 - 114. [Abstract] [Full Text] [PDF]