Role of AECG Monitoring for Atrial Fibrillation (A Fib)

It is estimated that AF is the source of 1 in 4 ischemic strokes. Stroke accounts for 1 in every 20 deaths in the United States and is a leading cause of serious long-term disability and health care expenditure. Cryptogenic stroke is the current term used to describe a symptomatic cerebral infarct for which no probable cause is identified following an adequate diagnostic evaluation. Initial work-up typically includes echocardiography, a 12-lead electrocardiogram (ECG), inpatient cardiac telemetry, or 24-h Holter monitoring, laboratory screening for hypercoagulable states.  

Atrial Fibrillation (A-Fib) is a complex rhythm that is proven to significantly increase risk for adverse events including heart attack, stroke and it can lead to thromboembolic stroke most commonly from emboli arising from the left atrial appendage.

During a normal heartbeat, the upper chambers (atria) and lower chambers (ventricles) of the heart work together to pump blood to the rest of the body. A-Fib occurs when the upper chambers of the heart beat irregularly and does not pump all of the blood to the lower chambers, causing some blood to pool and potentially form clots. If a clot breaks loose, it can travel through the bloodstream to the brain and lead to a stroke. Strokes related to AFib are often more severe compared to strokes with other underlying causes.  Atrial Fibrillation affects an estimated 2.7 million American each year with nearly 700,000 new cases detected each year.  Atrial Fibrillation is a key consideration for effective medical management.  With such a strong correlation between A Fib and adverse events, the medical community is seeking to improve methods to detect A Fib early on to reduce patient risk. 

Ambulatory cardiac (AECG) monitoring remains the most effective method of detecting atrial fibrillation.  However, selecting the right form of AECG monitoring for detecting a fib is not always a simple task.   Each form of AECG monitoring is useful but newer forms of AECG monitoring such as long-term continuous ECG monitoring and mobile cardiac telemetry (MCT) seem to have distinct technological advantages.  Evolving evidence suggests that a longer monitoring duration as well as acquiring continuous ECG data or Full-Disclosure has exponential benefits of detecting atrial fibrillation and other arrhythmias that may go undetected if asymptomatic in nature.