{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T16:42:59Z","timestamp":1787503379681,"version":"build-2736575974"},"reference-count":52,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","license":[{"start":{"date-parts":[[2024,7,30]],"date-time":"2024-07-30T00:00:00Z","timestamp":1722297600000},"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":["Circulation"],"published-print":{"date-parts":[[2024,7,30]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>Current estimates of atrial fibrillation (AF)\u2013associated mortality rely on claims- or clinical-derived diagnoses of AF, limit AF to a binary entity, or are confounded by comorbidities. The objective of the present study is to assess the association between device-recognized AF and mortality among patients with cardiac implantable electronic devices capable of sensitive and continuous atrial arrhythmia detection. Secondary outcomes include relative mortality among cohorts with no AF, paroxysmal AF, persistent AF, and permanent AF.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>Using the deidentified Optum Clinformatics US claims database (2015 to 2020) linked to the Medtronic CareLink database, we identified individuals with a cardiac implantable electronic device who transmitted data \u22656 months after implantation. AF burden was assessed during the first 6 months after implantation (baseline period). Subsequent mortality, assessed from claims data, was compared between patients with and without AF, with adjustment for age, geographic region, insurance type, Charlson Comorbidity Index, and implantation year.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>\n                      Of 21\u2009391 patients (age, 72.9\u00b110.9 years; 56.3% male) analyzed, 7798 (36.5%) had device-recognized AF. During a mean of 22.4\u00b112.9 months (median, 20.1 [12.8\u201329.7] months) of follow-up, the overall incidence of mortality was 13.5%. Patients with AF had higher adjusted all-cause mortality than patients without AF (hazard ratio, 1.29 [95% CI, 1.20\u20131.39];\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt;0.001). Among those with AF, patients with nonparoxysmal AF had the greatest risk of mortality (persistent AF versus paroxysmal AF: hazard ratio, 1.36 [95% CI, 1.18\u20131.58];\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt;.001; permanent AF versus paroxysmal AF: hazard ratio, 1.23 [95% CI, 1.14\u20131.34];\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt;.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>After adjustment for potential confounding factors, the presence of AF was associated with higher mortality in our cohort of patients with cardiac implantable electronic devices. Among those with AF, nonparoxysmal AF was associated with the greatest risk of mortality.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/circulationaha.124.069757","type":"journal-article","created":{"date-parts":[[2024,6,28]],"date-time":"2024-06-28T05:01:08Z","timestamp":1719550868000},"page":"350-361","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":20,"title":["Association of Atrial Fibrillation Burden and Mortality Among Patients With Cardiac Implantable Electronic Devices"],"prefix":"10.1161","volume":"150","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2388-8896","authenticated-orcid":true,"given":"Graham","family":"Peigh","sequence":"first","affiliation":[{"name":"Division of Cardiology, Northwestern University, Feinberg School of Medicine, Chicago, IL (G.P., K.T., T.N., 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(A.I.R.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Colleen","family":"Longacre","sequence":"additional","affiliation":[{"name":"Medtronic Inc, Minneapolis, MN (J.Z., S.C.R., A.I.R., C.L., D.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine","family":"Trinh","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Northwestern University, Feinberg School of Medicine, Chicago, IL (G.P., K.T., T.N., R.S.P.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9529-8908","authenticated-orcid":true,"given":"Tanvi","family":"Nayak","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Northwestern University, Feinberg School of Medicine, Chicago, IL (G.P., K.T., T.N., 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