{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T14:06:38Z","timestamp":1791209198046,"version":"4.1.0"},"reference-count":29,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"11","license":[{"start":{"date-parts":[[2024,11,1]],"date-time":"2024-11-01T00:00:00Z","timestamp":1730419200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Arrhythmia and Electrophysiology"],"published-print":{"date-parts":[[2024,11]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>Atrial fibrillation (AF) is associated with an increased risk of stroke, yet the limitations of conventional monitoring have restricted our understanding of AF burden risk thresholds. Predictive algorithms incorporating continuous AF burden measures may be useful for predicting stroke. This study evaluated the performance of temporal AF burden trends as predictors of stroke from a large cohort with insertable cardiac monitors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>Using deidentified data from Optum Clinformatics Data Mart (2007\u20132019) linked with the Medtronic CareLink insertable cardiac monitor database, we identified patients with an insertable cardiac monitor for AF management (n=1197), suspected AF (n=1611), and cryptogenic stroke (n=2205). Daily AF burden was transformed into simple moving averages, and temporal AF burden trends were defined as the comparison of unique simple moving average pairs. Classification trees were used to predict ischemic stroke, and AF burden significance was quantified using bootstrapped mean variable importance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>\n                      Of 5013 patients (age, 69.2\u00b111.7 years; 50% male; CHA\n                      <jats:sub>2<\/jats:sub>\n                      DS\n                      <jats:sub>2<\/jats:sub>\n                      -VASc, 3.7\u00b11.9) who met inclusion criteria, 869 had an ischemic stroke over 2\u2005409\u2005437 days total follow-up. Prior stroke or transient ischemic attack (variable importance, 13.13) was the number 1 predictor of future stroke followed by no prior diagnosis of AF (7.35) and AF burden trends in follow-up (2.59). Temporal proximity of AF and risk of stroke differed by device indication (simple moving averages: AF management, &lt;8 days and suspected AF and cryptogenic stroke, 8\u201321 days). Together, baseline characteristics and AF burden trends performed optimally for the area under the receiver operating characteristic curve (0.73), specificity (0.70), and relative risk (5.00).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>AF burden trends may provide incremental prognostic value as leading indicators of stroke risk compared with conventional schemes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/circep.123.012394","type":"journal-article","created":{"date-parts":[[2024,10,24]],"date-time":"2024-10-24T05:00:54Z","timestamp":1729746054000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":13,"title":["Performance of Atrial Fibrillation Burden Trends for Stroke Risk Stratification"],"prefix":"10.1161","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0772-2404","authenticated-orcid":true,"given":"Jonathan P.","family":"Piccini","sequence":"first","affiliation":[{"name":"Division of Cardiology, Duke Clinical Research Institute, Duke University Medical Center, Durham, NC (J.P.P.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-7781-356X","authenticated-orcid":true,"given":"Evan J.","family":"Stanelle","sequence":"additional","affiliation":[{"name":"Healthcare Economics (E.J.S.), Medtronic, Inc, Minneapolis, MN."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8547-072X","authenticated-orcid":true,"given":"Cody C.","family":"Johnson","sequence":"additional","affiliation":[{"name":"Clinical (C.C.J., D.S.), Medtronic, Inc, Minneapolis, MN."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8263-8304","authenticated-orcid":true,"given":"Elaine M.","family":"Hylek","sequence":"additional","affiliation":[{"name":"Boston University Medical Center, MA (E.M.H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rahul","family":"Kanwar","sequence":"additional","affiliation":[{"name":"Statistics (R.K.), Medtronic, Inc, Minneapolis, MN."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1492-2693","authenticated-orcid":true,"given":"Dhanunjaya R.","family":"Lakkireddy","sequence":"additional","affiliation":[{"name":"Kansas City Heart Rhythm Institute and Research Foundation, Overland Park (D.R.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8003-7254","authenticated-orcid":true,"given":"Suneet","family":"Mittal","sequence":"additional","affiliation":[{"name":"Valley Health System, Ridgewood, NJ (S.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5022-0461","authenticated-orcid":true,"given":"James","family":"Peacock","sequence":"additional","affiliation":[{"name":"White Plains Hospital, White Plains, NY (J.P.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3129-6161","authenticated-orcid":true,"given":"Andrea M.","family":"Russo","sequence":"additional","affiliation":[{"name":"Electrophysiology and Arrhythmia Services, Cooper University Hospital, Camden, NJ (A.M.R.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-7115-0914","authenticated-orcid":true,"given":"Dana","family":"Soderlund","sequence":"additional","affiliation":[{"name":"Clinical (C.C.J., D.S.), Medtronic, Inc, Minneapolis, MN."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8298-4418","authenticated-orcid":true,"given":"Mellanie True","family":"Hills","sequence":"additional","affiliation":[{"name":"StopAfib.org, American Foundation for Women\u2019s Health, Decatur, TX (M.T.H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8718-1534","authenticated-orcid":true,"given":"Rod S.","family":"Passman","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Northwestern University, Feinberg School of Medicine, Chicago, IL 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