Simulation of monitoring strategies for atrial fibrillation detection

Paroxysmal atrial fibrillation (PAF) is a difficult disorder to investigate because of its intermittent and sometimes asymptomatic nature. The aim of this study was to simulate several daily ECG monitoring strategies applied on data extracted from Burden II Study (patients implanted with pacemaker for Brady-Tachy Syndrome). Daily monitoring strategies were obtained by varying the following key parameters: the hour of the day when the monitoring begins, the duration of the recording during each day, and the number of consecutive days the monitoring lasts. The day when the monitoring starts was randomly chosen over the observational period. We found that a short-term daily ECG monitoring could be optimized if performed starting from 8 AM (almost 50% of diagnosed patients). Temporally-optimized monitoring allows to detect a higher percentage of patients than 1-day Holter monitoring and to be at least as effective as a 7-days 24h monitoring.