Study | n | Country | Type of patients used | Device used | Duration of recording (s) | Frequency of recording/ day | Total monitoring (days) | Mean/ median age (years) | Male (%) | BMI (kg/m2) | HTN (%) | DM (%) | IHD (%) | Previous diagnosis of AF (%) | HF (%) | Previous stroke (%) | Mean/ median CHADS/ CHA2DS2-VASC | Definition of AF | New AF (n) | New AF rate (%) |
Lowres et al 52 | 1000 | Australia | Community pharmacy screening | Alive Cor | 60 | 1 | 0 | 76 | 44 | NR | 62 | 23 | 16 | 10.4 | 3 | 7 | 3.3 | Cardiologist interpretation | 15 | 1.5 |
Svennberg et al 53 | 7173 | Sweden | Community screening (aged 75–76 years) | Zenicor | 30 | 2 | 14 | 75 | 46 | 25.9 | 50 | 11 | 9.2 | 9.2 | 3.4 | 9 | 3.4 | 30 s irregular rhythm without P waves or 2× episodes between 10 and 29 s | 218 | 3 |
Proietti et al 54 | 65 747 | Belgium | Belgian Heart Week screening | Omron Heartscan HCG-801 | 30 | 1 | 0 | 58 | 41 | NR | 36 | 21 | 23 | 0.5 | 20 | 20 | 2 | Irregular R-R interval, no distinct P waves, variable atrial cycle length | 603 | 1.1 |
Kaasenbrood et al 55 | 3269 | Holland | Influenza vaccination—opportunistic screening | MyDiagnostik | 60 | 1 | 0 | 64.1 | 49 | NR | NR | NR | NR | 2.6 | NR | NR | NR | Cardiologist interpretation×2 | 37 | 1.1 |
Engdahl et al 56 | 848 | Sweden | Community screening (aged 75–76 years) in Halmstad, Sweden | Zenicor | 30 | 2 | 14 | 75 | 43 | NR | 53 | 11 | NR | 9.6 | 4 | 10 | 1.9 | 30 s duration of irregular rhythm or ≥2 episodes of 10 s or more | 40 | 4.7 |
Hendrikx et al 57 | 928 | Sweden | GP practices | Zenicor | 10 | 2 | 28 | 69.8 | 50 | NR | 90.3 | 31.6 | 19.8 | 0 | 3.7 | 8.6 | 2 | 10 s irregular rhythm without P waves | 35 | 3.8 |
Hendrikx et al 67 | 95 | Sweden | Referred for presyncope/ palpitations | Zenicor | 30 | 2 | 28 | 54.1 | 44 | NR | 28.4 | 1.1 | 8.4 | 0 | 0 | 6.3 | 1 | 30 s irregular rhythm without P waves | 9 | 9.5 |
Chan et al 15 | 1013 | Hong Kong | Patients aged ≥65 years with HTN or diabetes | Alive Cor | 60 | 1 | 0 | 68.4 | 47 | NR | 90.4 | 36.6 | 16.2 | 2.2 | 4.4 | 10.5 | 3 | Cardiologist interpretation | 5 | 0.5 |
Doliwa Sobocinski et al 66 | 249 | Sweden | Patients post-TIA/ stroke | Zenicor | 10 | 2 | 30 | 72 | 57 | NR | 65 | 16 | 20 | 0 | 4 | 25 | 3 | Irregular rhythm of minimum 10 s without visible P waves | 15 | 6 |
Doliwa Sobocinski P et al 14 | 606 | Sweden | Community event | Zenicor | 10 | 1 | 0 | NR | 64 | NR | NR | NR | NR | NR | NR | NR | NR | Irregular rhythm without visible P waves | 6 | 1 |
Ramkumar et al 60 | 204 | Australia | Community aged ≥65 years with one or more risk factor for HF | Remon RM-100 | 60 | 5 | 7 | 70.1 | 51 | 29.1 | 72.1 | 56.4 | 5.9 | 0 | 0 | NR | 3 | 30 s duration of irregular rhythm with absent P waves | 20 | 9.8 |
Hendrikx et al 58 | 201 | Sweden | Patients referred to respiratory clinics with suspicion of obstructive sleep apnoea | Zenicor | 30 | 2 | 14 | 56 | 69 | 30 | 51 | 10 | 9.2 | 0 | 4.6 | 3.1 | NR | Irregular supraventricular extra systoles in series for 30 s | 13 | 6.5 |
Claes et al 61 | 10 758 | Belgium | Community heart rhythm screening programme through medical centres | Omron HeartScan HCG-801 | 30 | 1 | 0 | 59 | 38 | NR | 30.6 | 8.6 | 12.2 | 7.2 | 7.2 | 5.4 | 1 | Irregular RR intervals, absence of P waves and variable atrial cycle length (when visible) | 167 | 1.6 |
Samol et al 62 | 132 | Germany | Large proportion poststroke/TIA. Also recruited from diabetes, HTN and dyslipidemia clinics | Omron HeartScan HCG-801 | 30 | 1 | 0 | 64 | 58 | NR | 67 | 27 | NR | 0 | 3 | 49 | NR | Cardiologist Interpretation×2 | 7 | 5.3 |
Battipaglia et al 63 | 855 | UK | Community shopping centre screening | MyDiagnostik | 15 | 1 | 0 | NR | NR | NR | NR | NR | NR | NR | NR | NR | NR | NR | 7 | 0.8 |
Chan and Choy59 | 13 122 | Hong Kong | Nationwide community screening programme | Alive Cor | 30 | 1 | 0 | 64.7 | 29 | 23.7 | 38.2 | 14.8 | 2.2 | 0 | 0.7 | 2.8 | NR | Software algorithm definition with minimum of 30 s | 101 | 0.8 |
Chan et al 65 | 10 735 | Hong Kong | Nationwide community screening programme | Alive Cor | 30 | 1 | 0 | NR | NR | NR | NR | NR | NR | 1.2 | NR | NR | NR | Cardiologist interpretation (≥30 s) | 74 | 0.7 |
Halcox et al 64 | 501 | UK | Community based with individuals aged >65 years with CHA2DS2-VASC score≥2 | Alive Cor | 30 | 2× per week | 365 | 72.6 | 48 | NR | 54 | 26 | 14 | 0 | 1.0 | 7.0 | 3.0 | 30 s duration of an irregular rhythm without P waves | 19 | 3.8 |
Gladstone et al 18 | 277 | Canada | Patients admitted with cryptogenic stroke | Holter | Continuous | Continuous | 1 | 73.2 | 56 | NR | 67 | 19.3 | 14.7 | 0 | 7 | 12.6 | NR | 30 s or longer duration of irregular rhythm | 9 | 3.2 |
Barthélémy et al 19 | 60 | France | Consecutive patients admitted with stroke/TIA | Holter | Continuous | Continuous | 1 | 64.4 | 55 | NR | 50 | 17 | NR | 0 | NR | 27 | NR | Fibrillatory waves associated with irregular ventricular response ratio at least 30 s duration | 8 | 13.3 |
Jabaudon et al 20 | 149 | Switzerland | Consecutive patients admitted with stroke/TIA | Holter | Continuous | Continuous | 1 | 66.9 | 68 | NR | 58 | 16.7 | 16.8 | 4.7 | NR | 16.8 | NR | NR | 7 | 4.7 |
Koudstaal et al 21 | 100 | Holland | Retrospective study of 100 patients admitted with stroke/TIA | Holter | Continuous | Continuous | 1 | 60.9 | 74 | NR | NR | NR | 41 | NR | NR | NR | NR | NR | 5 | 5 |
Hornig et al 22 | 268 | Germany | Consecutive patients admitted with stroke/TIA | Holter | Continuous | Continuous | 1 | 59.1 | 61 | NR | 43.7 | 34 | NR | NR | 14.9 | 45 | NR | NR | 10 | 3.3 |
Rizos et al 23 | 496 | Germany | Patients admitted with stroke/TIA | Holter | Continuous | Continuous | 1 | 69 | 62 | NR | 78.8 | 24.6 | NR | NR | NR | 22.2 | 3 | Cardiologist interpretation (≥30 s) | 14 | 2.8 |
Schuchert et al 24 | 82 | Germany | Consecutive patients admitted with stroke/TIA | Holter | Continuous | Continuous | 3 | 59.7 | 57 | NR | 36.5 | NR | 17.1 | NR | NR | NR | NR | Small irregular baseline undulations of variable amplitudes and morphology at a rate >350/min with an irregular ventiruclar response for at least 1 min | 5 | 6 |
Schaer et al 25 | 241 | Switzerland | Consecutive patients admitted with stroke/TIA | Holter | Continuous | Continuous | 1 | 68.7 | 59 | NR | 76 | 25 | 41 | 7 | NR | 4.6 | NR | NR | 0 | 0 |
Schaer et al 26 | 425 | Switzerland | Retrospective review of patients poststroke/TIA with Holter monitoring | Holter | Continuous | Continuous | 1 | 67.4 | 61 | NR | NR | NR | NR | NR | NR | 1.2 | NR | Self-terminating sequence of >30 s of irregular RR intervals and the presence of fibrillatory P waves | 9 | 2.1 |
Shafqat et al 27 | 465 | Pakistan | Retrospective review of consecutive patients admitted with stroke/TIA | Holter | Continuous | Continuous | 1 | 66.8 | 56 | NR | NR | NR | NR | NR | NR | NR | NR | NR | 5 | 2.4 |
Lazzaro et al 28 | 133 | USA | Consecutive patients admitted with stroke/TIA | Holter | Continuous | Continuous | 1 | 63.1 | 50 | NR | 70 | 29.3 | 18.8 | 0 | NR | 2.3 | NR | Supraventricular tachyarrhythmia characterised by uncoordinated atrial activation with fibrillatory waves varying in amplitude, shape and timing, replacing consistent P waves and with a duration >30 s | 8 | 6 |
Grond et al 29 | 1135 | Germany | Patients admitted in seven German centres with stroke/TIA | Holter | Continuous | Continuous | 3 | 67 | 55 | 27.4 | 20.4 | 7.3 | 0 | 5.8 | 17.4 | NR | ≥1 period of >30 s duration of an absolute arrhythmia without detectable P waves and without a pattern more consistent with an alternate diagnosis | 49 | 4.3 | |
Stahrenberg et al 30 | 224 | Germany | Consecutive patients admitted with stroke/TIA | Holter | Continuous | Continuous | 7 | 68 | 58 | 27.6 | 72.9 | 22.3 | 14.8 | 0 | 5.2 | 16.2 | NR | 2x Cardiologist interpretation of software algorithm detection of events | 28 | 12.5 |
Ritter et al 31 | 60 | Germany | Patients admitted with cryptogenic stroke | Holter | Continuous | Continuous | 7 | 61.8 | 57 | NR | 70 | 11.7 | 13.3 | NR | 0 | NR | 4 | Cardiologist interpretation (>30 s) | 1 | 1.7 |
Higgins et al 32 | 50 | Scotland | Patients admitted with stroke/TIA | Holter | Continuous | Continuous | 7 | 67.1 | 48 | NR | 56 | 8 | 16 | 0 | NR | NR | NR | Cardiologist interpretation (>30 s) | 4 | 8 |
Hendrikx et al 67 | 95 | Sweden | Patients investigated for palpitations and presyncope | Holter | Continuous | Continuous | 1 | 54.1 | 42 | NR | 28.4 | 1.1 | 8.4 | 0 | 0 | 6.3 | 1 | 30 s irregular rhythm without P waves | 2 | 2.1 |
Thakkar and Bagarhatta33 | 52 | India | Consecutive patients admitted with stroke/TIA | Holter | Continuous | Continuous | 1 | 59.5 | 77 | NR | 51.9 | 23.1 | 15.4 | 0 | 1.7 | 7.7 | NR | 30 s irregular rhythm without P waves | 3 | 5.8 |
Wachter et al 34 | 198 | Germany | Consecutive patients admitted with stroke/TIA | Holter | Continuous | Continuous | 1 | 73.2 | 62 | NR | 80.7 | 26.4 | 9.1 | 0 | 4.6 | 21.7 | 4.8 | >30 s rhythm with irregular RR intervals and the presence of fibrillatory P waves | 9 | 5 |
Gumbinger et al 35 | 192 | Germany | Patients admitted with stroke/TIA | Holter | Continuous | Continuous | 1 | NR | NR | NR | NR | NR | NR | NR | NR | NR | NR | NR | 2 | 1 |
Alhadramy et al 36 | 426 | Canada | Retrospective review of patients poststroke/TIA with Holter monitoring | Holter | Continuous | Continuous | 1 | 64.9 | 48 | NR | 58.2 | 14.1 | 14.1 | 0 | 1.6 | 6.3 | NR | Irregular ventricular response in the absence of p waves or with fibrillatory waves | 11 | 2.5 |
Doliwa Sobocinski et al 66 | 249 | Sweden | Consecutive patients admitted with stroke/TIA | Holter | Continuous | Continuous | 1 | 72 | 57 | NR | 65 | 16 | 20 | 0 | 4 | 25 | 3 | Irregular rhythm of minimum 10 s without visible P waves | 5 | 2 |
Dangayach et al 37 | 51 | USA | Retrospective audit of patients admitted with cryptogenic stroke | Holter | Continuous | Continuous | 2 | 58.2 | 43 | NR | 35.3 | 16 | 15.7 | 7.4 | NR | NR | NR | NR | 15 | 29.4 |
Gunalp et al 38 | 26 | Turkey | Patients admitted with ischaemic stroke | Holter | Continuous | Continuous | 1 | 66 | 69 | NR | 61 | 26 | 31 | NR | NR | NR | NR | NR | 11 | 42.3 |
Fonseca et al 39 | 80 | Portugal | Patients admitted with cryptogenic stroke | Holter | Continuous | Continuous | 1 | 69.3 | 53 | NR | 71.3 | 28.8 | 11.3 | NR | NR | 22.5 | NR | NR | 17 | 21 |
Manina et al 40 | 114 | Italy | Patients admitted with cryptogenic stroke | Holter | Continuous | Continuous | 4 | 63.1 | NR | NR | 52.6 | 9.6 | NR | NR | NR | NR | NR | Irregular ventricular response in the absence of P waves or with fibrillatory waves | 29 | 25.4 |
Tagawa et al 41 | 308 | Japan | Consecutive patients admitted with ischaemic stroke | Holter | Continuous | Continuous | 1 | 72.6 | 60 | NR | 70.1 | 25.3 | NR | 20.4 | NR | NR | NR | Small irregular baseline undulations of variable amplitude and morphology at a rate of 300–350/min associated with irregular ventricular response | 26 | 8.4 |
Shibazaki et al 42 | 536 | Japan | Consecutive patients admitted with ischaemic stroke | Holter | Continuous | Continuous | 1 | 72.4 | 64 | NR | 65.9 | 25.7 | 9.8 | NR | 0.3 | NR | NR | NR | 12 | 2.2 |
Vandebroucke and Thijs43 | 136 | Belgium | Retrospective audit of patients admitted with ischaemic stroke | Holter | Continuous | Continuous | 1 | 68 | 52 | NR | NR | NR | NR | NR | NR | NR | NR | NR | 7 | 5.1 |
Yodogawa et al 44 | 68 | Japan | Consecutive patients admitted with ischaemic stroke | Holter | Continuous | Continuous | 1 | 69.9 | 54 | NR | 66.2 | 14.7 | NR | NR | NR | NR | NR | Irregular and uncoordinated atrial electrical activity on surface ECG lasting >30 s | 17 | 25 |
Atmuri et al 45 | 140 | Australia | Retrospective audit of patients admitted with ischaemic stroke/TIA | Holter | Continuous | Continuous | 1 | NR | NR | NR | 65 | 20 | 37.1 | 18.6 | NR | NR | NR | NR | 12 | 8.6 |
Salvatori et al 46 | 274 | Italy | Cohort study of patients aged ≥65 years with HTN in multiple GP clinics | Holter | Continuous | Continuous | 2 | 70 | 54 | NR | 100 | 15 | 9 | 7 | 4 | 2.2 | NR | Cardiologist interpretation | 4 | 1.5 |
Beaulieu-Boire et al 47 | 284 | Canada | Consecutive patients admitted with stroke/TIA | Holter | Continuous | Continuous | 1 | 70.6 | 52 | NR | 68.7 | 26.7 | 27.4 | NR | 2.2 | 22.3 | NR | Cardiologist interpretation | 18 | 6.3 |
Dogan et al 48 | 400 | Turkey | Retrospective review of patients admitted poststroke | Holter | Continuous | Continuous | 1 | NR | NR | NR | NR | NR | NR | NR | NR | NR | NR | NR | 40 | 10 |
Douen et al 49 | 126 | Canada | Retrospective review of patients admitted poststroke | Holter | Continuous | Continuous | 1 | NR | NR | NR | NR | NR | NR | 7 | NR | NR | NR | NR | 9 | 7.1 |
Suissa et al 50 | 354 | France | Consecutive patients admitted with ischaemic stroke | Holter | Continuous | Continuous | 1 | 62.4 | 57 | NR | 51.1 | 18.6 | NR | 0 | NR | NR | NR | Cardiologist interpretation | 2 | 0.6 |
Wohlfahrt et al 51 | 224 | Germany | Patients admitted with ischaemic stroke | Holter | Continuous | Continuous | 7 | 68.5 | 59 | NR | 73.2 | 22.3 | 15.2 | NR | 5.4 | 24.1 | NR | >30 s irregular rhythm | 29 | 12.9 |
AF, atrial fibrillation; BMI, body mass index; DM, diabetes mellitus; GP, general practitioner; HF, heart failure; HTN, hypertension; IHD, ischaemic heart disease.