28/07/2016 - Press release
By combining four simple indicators, researchers have developed a tool that allows you to accurately predict the risk of suffering atrial fibrillation in 2 to 3 years
Cardiologists at the Hospital del Mar and researchers from the Hospital del Mar Medical Research Institute (IMIM) have developed a new tool that enables them to estimate atrial fibrillation risk using electrocardiogram indicators, basic clinical data, and parameters obtained through Holter monitors (small electronic devices that record and store a patient's electrocardiogram for 24 hours). The results of the project have just been published in the International Journal of Cardiology.
Atrial fibrillation is a disease characterised by uncoordinated and disorganised atrial beats that produce a rapid and irregular heart rate. It is estimated that it affects between 1.5 and 2% of people in the developed world and the percentage increases with age. "Predicting it is a major clinical challenge. Atrial fibrillation is associated with a higher risk of suffering stroke, heart failure and mortality, but in 50% of cases it is an asymptomatic illness and is usually diagnosed when the adverse event occurs", explains Dr. Ermengol Vallès, head of the Electrophysiology and Arrhythmia Unit at the Hospital del Mar and a researcher in the Biomedical Research Group on Heart Disease at the IMIM.
The risk factors associated with atrial fibrillation include age, hypertension, diabetes mellitus, obesity, structural heart disease, heart failure, the deterioration of auriculoventricular flow, chronic obstructive pulmonary disease, and obstructive sleep apnoea. Several of these factors have been used to develop risk scores, but up to now there was no validated calculation tool that would allow cardiologists to estimate, simply and without aggressive technology, the risk of developing atrial fibrillation in the medium term.
The study involved the assessment of 299 patients from the Hospital del Mar's cardiology clinic, who wore a Holter monitor for a 24-hour period. Through multivariate analysis of the data, four independent predictors for atrial fibrillation were identified: age, the presence of heart failure or structural cardiomyopathy, the percentage of ?atrial extrasystoles, and the PR interval. These predictors were used to design the risk calculator and subsequently validate it in an independent cohort of 200 patients with similar basal characteristics to the first group. The results confirmed the fact that this new calculator precisely predicts the risk of atrial fibrillation at 2 and 3 years.
"The prevalence of atrial fibrillation has increased considerably in the past decade, becoming an epidemic in developed countries. The calculator we have developed can be used to identify those populations at a greater risk of developing this disease, meaning we can more closely monitor the most probable cases, prevent complications related to the disease, and reduce the associated social and economic costs", concludes Dr. Sandra Cabrera, a member of the Arrythmia Unit and first author of the study.
The calculator is intended to be used exclusively by medical personnel and is available on the website: http://afibcalculator.com/. The team is currently assessing whether to release it as an app.
Cabrera S, Vallès E*, Benito B, Alcalde O, Jiménez-López J, Fan R, Martí-Almor J. Simple predictors for new onset atrial fibrillation. Int J Cardiol 2016; 221: 515-520.