Atrial fibrillation detection with long-term continuous Holter ECG recording in patients with high cardiovascular risk and clinical palpitations: the prospective after study.

AIM: New technologic tools for continuous ECG monitoring have been developed to detect and treat atrial fibrillation (AF) in specific populations with high cardiovascular risk. We evaluated the prevalence and the management of AF diagnosed in patients with high cardiovascular risk and non-documented clinical palpitation undergoing systematic 14-day continuous ECG-Holter monitoring. METHODS: Patients were prospectively enrolled from December 2019 to December 2021 in this multicentre study, sponsored by the French National College of Cardiology. Patients met the following criteria: CHA2DS2VASc score ≥ 2 in males and ≥ 3 in females and clinical palpitations without previously documented arrhythmia. Enrolled patients underwent a continuous 14-day Holter-ECG monitoring for arrhythmia detection. RESULTS: Among the 336 included patients, 39% were male, 75% were greater than 65 years of age and 46.5% had suffered a prior stroke. AF was detected in 14% of patients, among which 23.4% were detected in the first 24 h of monitoring. Finally, age ≥ 65 years (p = 0.037) was significantly associated with AF, as well as male gender (p = 0.023) and a lower rate of antiplatelet therapy (p = 0.018). Patients with diagnosed AF had a prescription of anticoagulation therapy in 90%. Antiarrhythmic drugs were administered in 90% of AF patients and 13% underwent AF ablation. CONCLUSIONS: The systematic AF screening of patients with palpitations and high cardiovascular risk resulted in a diagnostic yield of AF in 14% of the population with a 14-day continuous ECG-Holter monitor. This strategy resulted in the prescription of anticoagulation and antiarrhythmic therapy in 90% of the AF detected population.

[Familial forms of interauricular communication of the ostium secundum type]. / Les formes familiales de communication interauriculaire de type ostium secundum.

The occurrence of several cases of ASD in the same family is rare. Familial forms of ASD are characterised by the high incidence of associated cardiac lesions in affected patients or in the family, by the frequency of atrioventricular block with prolongation of the PR interval and by the presence of a large defect in the interatrial septum. The condition is thought to be transmitted in an autosomal dominant manner. The authors report the case of a family in which 7 cases of ASD were found, 6 of which were repaired surgically. There were no associated cardiac or extracardiac malformations; AV conduction was normal in 4 of the 6 operated cases--the defects were all large. The study of the genealogical tree with examination of most members of the family suggests autosomal dominant transmission of the condition.