title: Paroxysmal atrial fibrillation with silent episodes: intermittent versus continuous monitoring.
abstract: OBJECTIVE
  Asymptomatic atrial fibrillation (AF) presents the same risk for cardioembolic events as symptomatic AF. Intermittent ECG recordings may be helpful in detecting asymptomatic paroxysmal arrhythmias. The objective of this study was to compare short intermittent heart rhythm recordings with or without symptoms with continuous ECG recordings.
  
  
  METHODS
  Twenty-two patients with diagnosed symptomatic paroxysmal AF participated. Patients used a handheld transtelephonic ECG device for a 30-day period performing two registrations of 10 seconds per day. Additionally patients were asked to make registrations if arrhythmia symptoms occurred. Patients also performed a 24-hour ambulatory continuous ECG recording during a single twenty-four hours period of the 30 day period. AF was defined as an irregular ventricular rhythm without visible p-waves for at least 10 seconds.
  
  
  RESULTS
  1425 intermittent ECG recordings were performed. AF episodes were diagnosed in 18 (82%) patients compared with 7 (32%) patients using continuous ECG, (p = 0.001). All patients with AF detected by continuous monitoring were also detected by intermittent recordings. Of the episodes, 16% were judged as symptomatic.
  
  
  CONCLUSIONS
  Short-term ECG registrations over extended time periods seem to be a more sensitive tool, compared with short continuous ECG recordings, for detection of AF episodes.
authors.affiliation: Karolinska Institutet, Department of Clinical Sciences, Division of Cardiovascular Medicine, Danderyds Hospital, Stockholm, Sweden. Piotr.Sobocinski-doliwa@ds.se
authors.forename: Piotr Sobocinski
authors.initials: PS
authors.lastname: Doliwa
authors.forename: Mårten
authors.initials: M
authors.lastname: Rosenqvist
authors.forename: Viveka
authors.initials: V
authors.lastname: Frykman
mesh_terms: D000368:Aged; D058070:Asymptomatic Diseases; D001281:Atrial Fibrillation / Q000175:diagnosis* / Q000503:physiopathology; D004562:Electrocardiography / Q000379:methods*; D015716:Electrocardiography, Ambulatory; D005260:Female; D006329:Heart Conduction System / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D013548:Sweden; D013686:Telemetry; D013997:Time Factors