RESUMO
United Nations General Assembly declared that 2023 will be celebrated as the International Year of Millets. Millets are a group of coarse grains from the Poaceae family that offer numerous benefits that align with various United Nations Sustainable Development Goals (UN SDGs). This review explores diverse contributions of millet cultivation, consumption, and value addition with UN SDGs. The millets help in combating hunger by providing economical sources of essential nutrients and diversifying diets, improving health through mitigating malnutrition and diet-related diseases. Millet's lower water demand and resilience to climatic stress help in sustainable water management. Millets reduce the risks associated with monoculture farming and promote sustainable agricultural practices. Similarly, millet plants need few chemical fertilizers, and the ecological damage associated with these plants is minimized. Millets can prevent soil degradation and conserve biodiversity. They can adapt to diverse cropping systems and support sustainable land practices. Millet cultivation reduces inequalities by empowering smallholder farmers and maintaining economic balance. The cultivation and trading of millets promote partnerships among governments, NGOs, and businesses for sustainable development. The ability of millet to contribute to poverty reduction, hunger alleviation, health improvement, environmental sustainability, and economic development makes millet a sustainable choice for a better world.
RESUMO
Consumer preferences refer to the subjective assessments of products and services expressed by individuals. The objective of this investigation aims to examine the preferences of consumers regarding dahi, followed by the development of a corresponding product. The initial phase of the experimental design involves understanding the interests of consumers and the variables that influence their purchasing intentions through the administration of a questionnaire. The subsequent phase entails the development of dahi in accordance with consumer preferences, followed by an assessment of its nutritional value, sensory acceptability, and storage study. Subsequently, a significant proportion of consumers (91%) expressed an interest for the introduction of a pineapple-flavour (61.5%) spoon-able dahi (77%) containing natural sugar (65%) and packaged in a cup (71.5%) within the market. To adjust the sweetness intensity of monk fruit, a series of preliminary experiments were carried out to regulate the concentration to a level that can be considered sensory acceptable, specifically 05 g/100 ml. Afterwards, dahi was prepared by altering the concentration of FPP (freeze-dried pine-apple pomace powder) within the range of 0.5 to 2.5 g/100 ml. Prepared dahi were further subjected to sensory evaluation and storage study. Based on the obtained results and sensory analyst feedback, we conclude that the dahi formulation TPM2 exhibits considerable organoleptic acceptance and also has the potential for industrial-scale production to cater wider consumer demands. Supplementary Information: The online version contains supplementary material available at 10.1007/s13197-023-05919-5.
RESUMO
Background: Estimating and analyzing trends and patterns of health loss are essential to promote efficient resource allocation and improve Peru's healthcare system performance. Methods: Using estimates from the Global Burden of Disease (GBD), Injuries, and Risk Factors Study (2019), we assessed mortality and disability in Peru from 1990 to 2019. We report demographic and epidemiologic trends in terms of population, life expectancy at birth (LE), mortality, incidence, prevalence, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) caused by the major diseases and risk factors in Peru. Finally, we compared Peru with 16 countries in the Latin American (LA) region. Results: The Peruvian population reached 33.9 million inhabitants (49.9% women) in 2019. From 1990 to 2019, LE at birth increased from 69.2 (95% uncertainty interval 67.8-70.3) to 80.3 (77.2-83.2) years. This increase was driven by the decline in under-5 mortality (-80.7%) and mortality from infectious diseases in older age groups (+60 years old). The number of DALYs in 1990 was 9.2 million (8.5-10.1) and reached 7.5 million (6.1-9.0) in 2019. The proportion of DALYs due to non-communicable diseases (NCDs) increased from 38.2% in 1990 to 67.9% in 2019. The all-ages and age-standardized DALYs rates and YLLs rates decreased, but YLDs rates remained constant. In 2019, the leading causes of DALYs were neonatal disorders, lower respiratory infections (LRIs), ischemic heart disease, road injuries, and low back pain. The leading risk factors associated with DALYs in 2019 were undernutrition, high body mass index, high fasting plasma glucose, and air pollution. Before the COVID-19 pandemic, Peru experienced one of the highest LRIs-DALYs rates in the LA region. Conclusion: In the last three decades, Peru experienced significant improvements in LE and child survival and an increase in the burden of NCDs and associated disability. The Peruvian healthcare system must be redesigned to respond to this epidemiological transition. The new design should aim to reduce premature deaths and maintain healthy longevity, focusing on effective coverage and treatment of NCDs and reducing and managing the related disability.
Assuntos
COVID-19 , Doenças não Transmissíveis , Infecções Respiratórias , Idoso , Feminino , Humanos , Recém-Nascido , Masculino , Pessoa de Meia-Idade , COVID-19/epidemiologia , Expectativa de Vida , Pandemias , Peru/epidemiologia , Anos de Vida Ajustados por Qualidade de Vida , Lactente , Pré-EscolarRESUMO
Wheatgrass is a valuable source of nutrients and phytochemicals with therapeutic properties. However, its shorter life span makes it unavailable for use. So, storage-stable products must be developed through processing in order to enhance its availability. Drying is a very important part of the processing of wheatgrass. Thus, in this study, the effect of fluidized bed drying on the proximate, antioxidant, and functional properties of wheatgrass was investigated. The wheatgrass was dried in a fluidized bed drier at different temperatures (50, 55, 60, 65, 70 °C) using a constant air velocity of 1 m/s. With increasing temperature, the moisture content was reduced at a faster rate, and all drying processes took place during the falling rate period. Eight mathematical models under thin layer drying were fitted into the moisture data and were evaluated. The Page model was the most effective in explaining the drying kinetics of wheatgrass, followed by the Logarithmic model. The R2, chi-square, and root mean squared value for Page model was 0.995465-0.999292, 0.000136-0.0002, and 0.013215-0.015058, respectively. The range of effective moisture diffusivity was 1.23-2.81 × 10-10 m2/s, and the activation energy was 34.53 kJ/mol. There was no significant difference in the proximate composition of was seen at different temperatures. The total phenolic content (117.16 ± 0.41-128.53 ± 0.55 mgGAE/g), antioxidant activity (33.56 ± 0.08-37.48 ± 0.08% (DPPH), and FRAP (1.372 ± 0.001-1.617 ± 0.001 mgAAE/g) increased with the rise in temperature. A significant increase was observed in functional properties, except for the rehydration ratio, which decreased with rising temperature. The current study suggests that fluidized bed drying improves the nutritional retention of wheatgrass with good antioxidant activity and functional properties that can be used to make functional foods.
RESUMO
This current research set out to characterize Halari donkey milk by investigating its nutritional constituents, including its proximate analysis, water activity, titratable acidity, energy, and microbiological analysis. A comprehensive profiling of vitamins, minerals, and amino acids was also carried out. It was found that the composition of Halari donkey milk was consistent with previously published donkey milk literature and was comparable to that of human milk. Halari donkey milk has low 0.86 ± 0.04% fat content, 2.03 ± 0.03% protein content, 0.51 ± 0.05% ash content, and high 5.75 ± 0.15% lactose content making it sweet and palatable. The energy content of Halari donkey milk was 40.39 ± 0.31 kcal/100 g, and the water activity ranged from 0.973 to 0.975. Titratable acidity was 0.03 ± 0.01%. Halari donkey milk can be considered acceptable and microbiologically safe, having low total plate count and yeast and mould counts. Mineral testing revealed that Halari donkey milk included significant amounts of magnesium, sodium, calcium, potassium, phosphorus, and zinc. The concentration of different vitamins and amino acids such as isoleucine and valine also contribute to the nutritional value of Halari donkey milk.
RESUMO
The beet-root (Beta vulgaris) and whey powder together, can potentially use as a multifunctional ingredient in the manufacturing of the "Popsicles", due to their biochemical composition that can enhance the concentration of bioactive compounds. In the present study, beet-root juice concentrates were prepared at different time/temperature treatments viz 45 °C, 55 °C, and 65 °C for 120, 80 and 45 min. The effect of different time/temperature treatments on physicochemical composition, colour, antioxidant activity (%), bioactive compounds, spectral data and sensory acceptance were evaluated. The physicochemical parameters of popsicles (PTI, PT2, PT3) including protein, total phenols, betalain, radical scavenging activity %, colour and melting values were significantly affected (p ≤ 0.05) by the different time/temperature treatments. The concentration of betalain and protein in all the popsicles ranged from 1134 to 1299 mg/L and 1.92 to 1.54 g/100 g respectively. The reduction of bioactive components viz betacyanins, betaxanthins, betanin, oxalic and syringic acid was also observed in popsicle (PTI) as compared to control. Furthermore, popsicle (PT1) was prepared with beet-root juice concentrated at 45 °C showed maximum sensory acceptance. The physicochemical and organoleptic attributes of processed popsicles encourage the commercial usage of whey powder and concentrated beetroot juice.
RESUMO
Colostrum samples of recently registered cow breed "Himachali Pahari" were assorted from high altitude zone (901-2200 m). Prepared bovine colostrum whey powder (BCWP) was analysed for chemical composition, amino acids, minerals, surface morphology (SEM-EDS), FTIR and dielectric properties. Results showed that freeze-dried BCWP contained a considerable amount of nutritional parameters viz IgG (18.55 g/100 g), protein (71.72 g/100 g) and total amino acids (69.64 g/100 g). Additionally, the concentration of essential minerals was found to be adequate, and there was no presence of heavy metals. The BCWP exhibits good dielectric properties (resistance â¼57 M-Ω). SEM-EDS showed the broken up-wards layer structure with the uniform distribution of minerals on the surface. The FTIR spectra confirmed the presence of a higher proportion of ß-sheets and ß-turn structures in BCWP. Thus, on account of good functional and nutritive properties, BCWP could be foreseen as the future of functional food.
RESUMO
In addition to providing individualized, specific, and ample nutritional compounds, donkey milk (DM) offers immunological modulation during health and disease. Recently, DM has attracted major interest in preparing infant formulas due to its similarity to human milk in terms of high protein and lactose content and low-fat concentration. The antimicrobial, anti-inflammation, antioxidant, and hypo-allergenicity properties of DM in human infants are well-documented. The purpose of this review is to summarize the knowledge of studies done in characterizing the composition of DM, including bioactive macronutrient levels influenced by the lactation status. The manufacture of DM-based food products and promising therapeutic applications in humans will also be discussed. The beneficial health effects of DM have been extensively studied as a valuable alternative source to breast milk. DM has proven to be a suitable nutrient to relieve milk-related allergies in human infants as opposed to cow's milk. Factors that influence the levels of macronutrients in DM include lactation status, processing, and manufacturing techniques. A wide variety of dairy products have been prepared using DM, such as cheese, ice cream, milk powder, novel functional fermented beverages, and milk powder for infant formulas. The bioactive macromolecules of DM exhibit antibacterial, antiviral, and antifungal effects as well as hypo-allergenicity, anti-inflammation, and antioxidant properties.
Assuntos
Doenças dos Bovinos , Hipersensibilidade a Leite , Alérgenos , Animais , Antioxidantes , Bovinos , Equidae , Feminino , Humanos , Hipersensibilidade a Leite/veterinária , Leite Humano , PósRESUMO
Bovine colostrum (BC) is the initial mammary secretion after parturition, which is nature's bountiful source consisting of nutritional and bioactive components present in a highly concentrated low-volume format. All mammalian newborns require colostrum to enhance physiological processes such as lifelong immunity, gastrointestinal development, and resistance to microbial infections. The genetic, environmental, and processing methods can all have an impact on the biochemical contents of BC and its supplements. BC and its derivatives have been intensively researched for their potential use in functional foods, medicines, and animal feed. Evidence from clinical studies suggests that BC products are well-tolerated, nontoxic, and safe for human ingestion. Functional foods, feed, and pharmaceutical formulations based on bovine colostrum are playing noteworthy roles in the development of innovative products for promoting health and the prevention of chronic illnesses. This systematic review sheds light on recent research on (a) the effects of processing techniques on BC components, (b) emerging techniques used in the isolation and identification of novel components, (c) BC-based functional foods for human consumption and animal feed supplements, and (d) the role of BC in current drug delivery, as well as future recommendations.
Assuntos
Colostro , Alimento Funcional , Animais , Bovinos , Colostro/química , Comércio , Suplementos Nutricionais , Feminino , Trato Gastrointestinal , GravidezRESUMO
Based on the availability of many nutrients, Moringa oleifera tree leaves have been widely employed as nutrients and nutraceuticals in recent years. The leaves contain a small amount of anti-nutritional factors and are abundant in innumerable bioactive compounds. Recently, in several in vivo and in vitro investigations, moringa leaves' bioactive components and functionality are highlighted. Moringa leaves provide several health advantages, including anti-diabetic, antibacterial, anti-cancer, and anti-inflammatory properties. The high content of phytochemicals, carotenoids, and glucosinolates is responsible for the majority of these activities as reported in the literature. Furthermore, there is growing interest in using moringa as a value-added ingredient in the development of functional foods. Despite substantial study into identifying and measuring these beneficial components from moringa leaves, bioaccessibility and bioavailability studies are lacking. This review emphasizes recent scientific evidence on the dietary and bioactive profiles of moringa leaves, bioavailability, health benefits, and applications in various food products. This study highlights new scientific data on the moringa leaves containing nutrient and bioactive profiles, bioavailability, health benefits, and uses in various food items. Moringa has been extensively used as a health-promoting food additive because of its potent protection against various diseases and the widespread presence of environmental toxins. More research is needed for utilization as well as to study medicinal effects and bioaccesibility of these leaves for development of various drugs and functional foods.
RESUMO
Mushrooms are well-known functional foods due to the presence of a huge quantity of nutraceutical components. These are well recognized for their nutritional importance such as high protein, low fat, and low energy contents. These are rich in minerals such as iron, phosphorus, as well as in vitamins like riboflavin, thiamine, ergosterol, niacin, and ascorbic acid. They also contain bioactive constituents like secondary metabolites (terpenoids, acids, alkaloids, sesquiterpenes, polyphenolic compounds, lactones, sterols, nucleotide analogues, vitamins, and metal chelating agents) and polysaccharides chiefly ß-glucans and glycoproteins. Due to the occurrence of biologically active substances, mushrooms can serve as hepatoprotective, immune-potentiating, anti-cancer, anti-viral, and hypocholesterolemic agents. They have great potential to prevent cardiovascular diseases due to their low fat and high fiber contents, as well as being foremost sources of natural antioxidants useful in reducing oxidative damages. However, mushrooms remained underutilized, despite their wide nutritional and bioactive potential. Novel green techniques are being explored for the extraction of bioactive components from edible mushrooms. The current review is intended to deliberate the nutraceutical potential of mushrooms, therapeutic properties, bioactive compounds, health benefits, and processing aspects of edible mushrooms for maintenance, and promotion of a healthy lifestyle.
RESUMO
This study aimed to determine the effect and potential of red rice in conjunction with barley and rhododendron extracts to develop a new variant of beer. In this study red rice, barley, and rhododendron extracts were used in different combinations and the best combination was selected based on quality and sensory characteristics. The results showed that the developed beer was rich in antioxidant activity (47.68 ± 0.96) and contained a good amount of anthocyanin (35.12 ± 0.79), flavonoids (0.119 ± 0.002), and polyphenols (0.410 ± 0.002). The red rice has more dietary significance than that of polished or milled rice, further, the use of rhododendron provides a large number of secondary metabolites such as tannins, saponins, alkaloids, tannins, and flavonoids. Besides, the sensory profile of the developed beer was quite distinct in terms of aroma, taste, and color from other alternatives available in the market.
RESUMO
Worksite health and wellness (WH&W) are gaining popularity in targeting cardiovascular (CV) risk factors among various industries. India is a large country with a larger workforce in the unorganized sector than the organized sector. This imbalance creates numerous challenges and barriers to implementation of WH&W programs in India. Large scale surveys have identified various CV risk factors across various industries. However, there is scarcity of published studies focusing on the effects of WH&W programs in India. This paper will highlight: 1) the current trend of CV risk factors across the industrial community, 2) the existing models of delivery for WH&W in India and their barriers, and 3) a concise evidence based review of various WH&W interventions in India.
Assuntos
Doenças Cardiovasculares/prevenção & controle , Promoção da Saúde , Serviços de Saúde do Trabalhador/métodos , Saúde Ocupacional , Serviços Preventivos de Saúde/métodos , Comportamento de Redução do Risco , Local de Trabalho , Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/epidemiologia , Atenção à Saúde , Países em Desenvolvimento , Política de Saúde , Humanos , Índia/epidemiologia , Programas Nacionais de Saúde , Prognóstico , Desenvolvimento de Programas , Medição de Risco , Fatores de RiscoRESUMO
Continuous long-term monitoring of atrial fibrillation (AF) and tachycardia (AT) is an unmet clinical need, which could be met with a chronically-implanted monitor. Improved therapeutic decisions based on accurate monitoring of parameters, such as daily AF/AT burden (hours/ day) may lead to improvements in clinical outcomes such as reduction in hospitalizations, symptoms, and strokes. This paper describes an AF/AT detector that detects AF as well as AT with an irregular ventricular response, and a supplementary AT detector for AT with more regular ventricular response. Seven databases with significant durations of AF, AT, and sinus rhythm were used to evaluate the performance of the detectors. All patient records with AF (N = 124) were detected by the AF/AT detector to have AF/AT burden with a mean, median, and 75 percentile of absolute error in burden detection of 8.8, 0, and 4 min, respectively. In patients having AF burden (= or > 10 min), the AF/AT detector was found to have burden accuracy within 20% of true burden in 96% of patients. The specificity was 94%, defined as follows: in patient records without AF/AT (N = 174), the percentage with AF/AT burden = or < 10 min in the 24-h recordings. The AF/AT detector underestimatesAT burden, thus degrading performance, in patients with significant amounts of AT with more regular ventricular response. The supplementary AT detector reduces the underestimation of AT while overestimating burden in patients without a significant amount of AT. The detectors described here could be implemented in an implantable monitor for accurate long-term AF/AT monitoring.
Assuntos
Algoritmos , Fibrilação Atrial/diagnóstico , Diagnóstico por Computador/métodos , Eletrocardiografia Ambulatorial/métodos , Reconhecimento Automatizado de Padrão/métodos , Processamento de Sinais Assistido por Computador , Taquicardia Atrial Ectópica/diagnóstico , Eletrocardiografia Ambulatorial/instrumentação , Humanos , Próteses e ImplantesRESUMO
Cardiovascular disease is a leading cause of global mortality, accounting for almost 17 million deaths annually or 30% of all global mortality. In developing countries, it causes twice as many deaths as HIV, malaria and TB combined. It is estimated that about 40-50% of all cardiovascular deaths are sudden cardiac deaths (SCDs) and about 80% of these are caused by ventricular tachyarrhythmias. Therefore, about 6 million sudden cardiac deaths occur annually due to ventricular tachyarrhythmias. The survival rate from sudden cardiac arrest is less than 1% worldwide and close to 5% in the US. Prevention of cardiovascular disease by increasing awareness of risk factors such as lack of exercise, inappropriate diet and smoking has reduced cardiovascular mortality in the US over the past few decades. However, there is still a huge cardiovascular disease burden globally as well as in the US. Therefore, there is a need to develop complementary strategies for management of sudden cardiac death. The data from several trials conclusively indicate that implantable defibrillators improve mortality in patients who have experienced an episode or are at high risk of developing ventricular tachyarrhythmias. These devices are reimbursed and are being used frequently in the developed economies for management of SCD. However, due to that low level of public and private health spending in developing economies and the relatively high cost of ICDs, their implant rates are very low there. The Automatic External Defibrillators and Emergency Medical Response Services equipped with AEDs provide complementary as well as alternative opportunities for management of SCD. There are several challenges associated with the adoption of these strategies. The efficacy and cost-effectiveness of these strategies need to be compared with ICDs to determine the appropriate strategy for various geographies. The global problem of SCD as well as the various options for its management will be discussed in the presentation.
Assuntos
Morte Súbita Cardíaca/epidemiologia , Morte Súbita Cardíaca/prevenção & controle , Saúde Global , Medição de Risco/métodos , Humanos , Incidência , Fatores de RiscoRESUMO
OBJECTIVES: This study was designed to investigate a practical alternative to His bundle pacing after atrioventricular (AV) junctional ablation by pacing a small area of isolated atrial tissue surrounding the AV node. BACKGROUND: His bundle pacing is preferred after AV junctional ablation in patients with refractory atrial fibrillation. However, it is technically difficult and not clinically useful at the present time. METHODS: This study was conducted in an isolated working swine heart model (n = 5), with real-time imaging capabilities. A small area of atrial tissue surrounding the AV node and the His bundle was isolated using sequential radiofrequency ablation lesions. RESULTS: Complete AV block created by segmental atrial isolation was achieved in 5 of 5 experiments. The isolated atrial segment was bordered by the ablation lines, the tricuspid annulus, and the AV node-His bundle. The AV conduction was characterized using a pacing electrode implanted into the isolated atrial segment. Pacing from the atria, the ventricles, and the isolated atrial segment at different rates confirmed complete bidirectional block between the atria and isolated area, whereas antegrade and retrograde AV nodal conduction between the isolated atrial segment and the ventricles remained intact. Pacing from the isolated area produced minimal changes in systolic left ventricular pressure compared with baseline sinus rhythm (mean -2 mm Hg). CONCLUSIONS: Isolation of a small area of atrial tissue surrounding the AV node is feasible by transcatheter radiofrequency ablation. This procedure may be a useful alternative to conventional AV junctional ablation because it can create complete AV block, while in effect permitting the equivalent of His bundle pacing after AV junctional ablation.
Assuntos
Nó Atrioventricular/cirurgia , Estimulação Cardíaca Artificial/métodos , Ablação por Cateter , Animais , Fascículo Atrioventricular , SuínosRESUMO
BACKGROUND: The ability of intermittent or symptom-based monitoring to accurately identify patients with atrial tachycardia/atrial fibrillation (AT/AF) and to quantify AT/AF burden is not well established. OBJECTIVES: The purpose of this study was to compare intermittent and symptom-based monitoring to continuous monitoring for (1) identification of patients with any AT/AF, (2) identification of patients with long-duration AT/AF, and (3) assessment of AT/AF burden. METHODS: Data from 574 pacemaker (AT500, Medtronic) patients were analyzed retrospectively over 1 year. The device recorded the amount of AT/AF detected each day. Intermittent monitoring (annual, quarterly, and monthly 24-hour Holter; 7-day and 30-day annual long-term recordings) was simulated by analyzing data from randomly selected days within a prescribed monitoring window. Symptom-based monitoring was approximated by analyzing days when patients indicated symptoms with an external activator. RESULTS: All intermittent and symptom-based monitoring resulted in significantly lower sensitivity (range 31%-71%) and negative predictive value (range 21%-39%) for identification of patients with any AT/AF (P <.001) and underestimated AT/AF burden (P <.001) compared with continuous monitoring. Sensitivity for identifying patients with long-duration episodes ranged from 23% to 58% (P <.001 vs continuous monitoring). Identification of patients with AT/AF and assessment of AT/AF burden with intermittent monitoring depended on the patient's actual AT/AF burden and improved with increasing frequency or duration of intermittent monitoring. CONCLUSION: Intermittent and symptom-based monitoring is highly inaccurate for identifying patients with any or long-duration AT/AF and for assessing AT/AF burden. Further investigation is required to determine if full AT/AF disclosure with implantable devices is effective in reducing stroke risk and facilitating maintenance of sinus rhythm.
Assuntos
Fibrilação Atrial/fisiopatologia , Desfibriladores Implantáveis , Eletrocardiografia Ambulatorial/métodos , Sistema de Condução Cardíaco/fisiopatologia , Taquicardia Supraventricular/fisiopatologia , Idoso , Fibrilação Atrial/diagnóstico , Fibrilação Atrial/terapia , Estimulação Cardíaca Artificial , Feminino , Seguimentos , Humanos , Masculino , Valor Preditivo dos Testes , Projetos de Pesquisa , Estudos Retrospectivos , Sensibilidade e Especificidade , Taquicardia Supraventricular/diagnóstico , Taquicardia Supraventricular/terapia , Fatores de TempoRESUMO
INTRODUCTION: Previous reports demonstrate that individual patients may have distinctive electrocardiographic patterns preceding atrial fibrillation (AF) onset. However, these observations are based on single recordings, and are thus limited by their "snapshot" derivation; it is unclear whether patterns observed on these recordings are consistent over time. We hypothesized that the use of an implantable loop recorder (ILR) would be feasible for serial, long-term characterization of electrocardiographic events preceding AF onset. METHODS AND RESULTS: An ILR was implanted in 29 patients with AF. Patients were instructed to activate the device immediately upon experiencing AF symptoms. Analysis focused on the electrocardiographic segment immediately preceding AF; each segment was classified as one of six patterns: short/long, normal sinus rhythm, absolute sinus bradycardia, relative sinus bradycardia, absolute sinus tachycardia, or relative sinus tachycardia. From a total of 318 device activations, 105 AF onsets were suitable for analysis, acquired from 21 patients over a mean follow-up interval of 7 months. Although AF was frequently triggered by an atrial premature beat that emerged during normal sinus rhythm, most patients demonstrated a variety of onset patterns. Degeneration of uniform atrial tachycardia to AF was rare. Significant delay in device activation relative to AF onset was common, as was activation in the absence of AF. CONCLUSIONS: Using the ILR, serial, long-term characterization of electrocardiographic events preceding AF onset was feasible, and typically demonstrated a varied pattern within individuals. There was significant incongruity between symptomatic and electrocardiographic AF burden. As described here, ILR technology is inadequate for the purpose of accurate characterization of AF burden.