• Marcelo Lapa Kruse, José Cláudio Lupi Kruse, Tiago Luiz Luz Leiria, Leonardo Martins Pires, Caroline Saltz Gensas, Daniel Garcia Gomes, Douglas Boris, Augusto Mantovani, and Gustavo Glotz de Lima.
• Instituto de Cardiologia, Fundação Universitária de Cardiologia, Porto Alegre, Rio Grande do Sul, Brazil.
• Sao Paulo Med J. 2014 Dec 1; 132 (6): 359363359-63.

Context And ObjectiveOccurrences of asymptomatic atrial fibrillation (AF) are common. It is important to identify AF because it increases morbidity and mortality. 24-hour Holter has been used to detect paroxysmal AF (PAF). The objective of this study was to investigate the relationship between occurrence of PAF in 24-hour Holter and the symptoms of the population studied.Design And SettingCross-sectional study conducted at a cardiology hospital.Methods11,321 consecutive 24-hour Holter tests performed at a referral service were analyzed. Patients with pacemakers or with AF throughout the recording were excluded.ResultsThere were 75 tests (0.67%) with PAF. The mean age was 67 ± 13 years and 45% were female. The heart rate (HR) over the 24 hours was a minimum of 45 ± 8 bpm, mean of 74 ± 17 bpm and maximum of 151 ± 32 bpm. Among the tests showing PAF, only 26% had symptoms. The only factor tested that showed a correlation with symptomatic AF was maximum HR (165 ± 34 versus 147 ± 30 bpm) (P = 0.03). Use of beta blockers had a protective effect against occurrence of PAF symptoms (odds ratio: 0.24, P = 0.031).ConclusionsPAF is a rare event in 24-hour Holter. The maximum HR during the 24 hours was the only factor correlated with symptomatic AF, and use of beta blockers had a protective effect against AF symptom occurrence.

19 keywords...

hide…