IJC Hea & Vascula u e 51 (2024) 101369
A ailable online 21 Feb ua y 2024
2352-9067/© 2024 The Au ho s. Published by Else ie B.V. This is an open access a icle unde he CC BY-NC-ND license (h p://c ea i ecommons.o g/licenses/by-
nc-nd/4.0/).
Ve y-ea ly de ec ion o a ial ib illa ion a e abla ion e alua ed by a
wea able ECG-pa ch p edic s la e blanking pe iod ecu ence: P elimina y
da a om a p ospec i e egis y
Miguel Ma ques An unes
a
,
b
,
1
,
*
, Ped o Sil a Cunha
a
,
c
,
1
, B´
a ba a Lace da Teixei a
a
,
1
,
Guilhe me Po ugal
a
,
c
, B uno Valen e
a
,
1
, Ana Lousinha
a
,
1
, Ana So ia Delgado
a
,
1
,
Sand a Al es
a
,
1
, C´
a ia Gue a
a
,
1
, Rui C uz Fe ei a
a
,
1
, M´
a io Ma ins Oli ei a
a
,
c
,
1
a
Ca diology Depa men , Hospi al San a Ma a, Cen o Hospi ala Uni e si ´
a io de Lisboa Cen al, Cen o Clínico Acad´
emico de Lisboa (CCAL), Lisbon, Po ugal
b
Clinical Pha macology and The apeu ics Uni - Cen o Ca dio ascula Da Uni e sidade de Lisboa (CCUL@RISE), Faculdade de Medicina Da Uni e sidade de Lisboa
c
Faculdade de Medicina, CCUL, Uni e sidade de Lisboa, Lisbon, Po ugal
ARTICLE INFO
Keywo ds:
A ial ib illa ion
A y hmia
Blanking pe iod
Ex e nal loop eco de
Recu ence
Abla ion
ABSTRACT
In oduc ion: A ial ib illa ion (AF) abla ion ep esen s a sa e and e ec i e p ocedu e o es o e sinus hy hm.
The idea ha pos -p ocedu al AF episodes - du ing he blanking pe iod - a e no conside ed ea men ailu e has
been inc easingly challenged. The E-Pa ch, a single-use adhesi e elec ode, acili a es ex ended con inuous ECG
moni o ing o 120 h. This pilo s udy aims o assess he e ec i eness o his ambula o y moni o ing de ice and
in es iga e whe he e y-ea ly AF ecu ence co ela es wi h delayed blanking pe iod abla ion ou comes.
Me hods: We conduc ed a single-cen e , p ospec i e, longi udinal s udy, including consecu i e pos -abla ion
pa ien s moni o ed wi h he E-pa ch. The abili y o he de ice o con inuously eco d was analyzed, as well as
he occu ence o AF episodes du ing ex e nal 7-day loop- eco de in he 2nd-mon h pos -abla ion.
Resul s: We included 40 pa ien s, median age 62 yea s (IQR 56–70). E-Pa ch moni o ing was ob ained o a
median o 118 h (IQR 112–120), wi h no discom o no in e p e a ion a e ac s. Ve y-ea ly AF ecu ence was
de ec ed in 11 (27.5 %) pa ien s, wi h a median AF bu den o 7 % (IQR 6 %–33 %). La e-blanking pe iod AF was
de ec ed in 13 (33 %) o he ex e nal 7-day loop eco dings. O he 11 pa ien s ha had e y-ea ly AF ecu ence,
10 (91 %) had la e-blanking AF. Ve y-ea ly AF de ec ion showed 77 % (95 % CI 64 %-90 %) sensi i i y and 96 %
(95 % CI 90–100 %) speci ici y in p edic ing la e-blanking AF, wi h a non-pa ame ic ROC cu e AUC o 0.903
(95 % 0.797––1.0).
Conclusion: The E-Pa ch was able o de ec e y-ea ly AF du ing an ex ended pe iod. Ve y-ea ly AF de ec ion
eme ges as a p edic o o AF ecu ence du ing he la e blanking pe iod pos -abla ion.
1. In oduc ion
A ial ib illa ion (AF) abla ion h ough pulmona y ein isola ion
(PVI) is a sa e and e icacious p ocedu e o achie ing sinus hy hm in
pa ien s wi h pa oxysmal o pe sis en AF [1]. An ea ly hy hm con ol
s a egy has shown clinical bene i and is cu en ly he p e e ed
pa hway o mos symp oma ic pa ien s wi h AF.[1,2] When choosing
he s a egy o hy hm con ol, AF abla ion has been shown o pe o m
be e han an ia hy hmics in imp o ing quali y o li e and educing
symp oms and AF bu den.[3] Addi ionally, in he EARLY-AF ial, pa-
ien s wi h pa oxysmal AF unde going c yoballoon abla ion we e shown
o ha e a lowe a e o AF ecu ence and he apy- ela ed ad e se ou -
comes.[4].
While being es ablished as an e icien and bene icial he apeu ic
in e en ion, a signi ican p opo ion o pa ien s expe ience AF ecu -
ence a e abla ion.[1,5] Risk ac o s associa ed wi h ecu ence
include non-pa oxysmal AF, old age, le a ial (LA) size, and concomi-
an como bidi ies - such as hea ailu e, hype ension, and obs uc i e
* Co esponding au ho a : Hospi al San a Ma a - Ca diology Se ice - A hy hmology, Pacing, and Elec ophysiology Uni , R. de San a Ma a 50, 1169-024 Lisboa,
Po ugal.
E-mail add ess: [email p o ec ed] (M. Ma ques An unes).
1
This au ho akes esponsibili y o all aspec s o he eliabili y and eedom om bias o he da a p esen ed and hei discussed in e p e a ion.
Con en s lis s a ailable a ScienceDi ec
IJC Hea & Vascula u e
jou nal homepage: www.sciencedi ec .com/jou nal/ijc-hea -and- ascula u e
h ps://doi.o g/10.1016/j.ijcha.2024.101369
Recei ed 10 Decembe 2023; Recei ed in e ised o m 23 Janua y 2024; Accep ed 18 Feb ua y 2024
IJC Hea & Vascula u e 51 (2024) 101369
2
sleep apnea (OSA).[6] Di e en sco es ha e been de eloped o e alua e
he isk o AF ecu ence, bu hey ha e gene ally unde pe o med.[6]
O no e, a ele an p edic i e alue o ea ly AF ecu ence, has eme ged
as a s ong indi idual p edic o o la e AF ecu ence [6–8].
Ea ly AF ecu ence is de ined as he occu ence o AF wi hin 3
mon hs ollowing abla ion. This pe iod o ea ly ecu ence – he
blanking pe iod – was i s desc ibed 20 yea s ago when i was obse ed
ha 15–49 % o pa ien s ha had a ecu ence in his pe iod ended up
ha ing delayed cu e om AF on a longe ollow-up.[9–12] Concu en
p o and an i-a hy hmic ac o s compe e in his ea ly pe iod.[12] Tissue
ischemia and p oli e a ion, ansien local in lamma ion, cellula
oxida i e s ess, ne e sp ou ing and issue nec osis due o ca he e
abla ion con ibu e o AF ecu ence, whe eas pa asympa he ic dene -
a ion, sca ma u a ion and mechanical s abiliza ion con ibu e as
p o ec i e p ocesses.[12] These mul i ac o ial inpu s lead o a s ong
p edic o o la e ecu ence ha is s ill a subjec o ac i e in es iga ion,
namely ega ding he 3-mon h cu o du a ion and he a hy hmic
bu den du ing he blanking pe iod, wi h newe e idence poin ing o a
e y high isk o AF a 12 mon hs ollow-up o pa ien s wi h ea ly AF
ecu ence[7,13].
While un il ecen ly we ha e been using adi ional ECG and Hol e
moni o ing able o moni o AF ecu ence, new sma gadge s and
wea able de ices a e now a ailable o hea hy hm moni o ing. Single-
use adhesi e elec odes, such as he E-Pa ch (Bio Tel Hea ), allow o
con inuous ECG moni o ing o up o 120 h. This new moni o ing mo-
dali y makes i easie o ollow hea a e and hy hm on an ou pa ien
basis in he immedia e pe iod a e PVI (Fig. 1).
In his pilo s udy, we se ou o assess he abili y o his con inuous
ambula o y moni o ing wea able de ice o de ec AF, and whe he e y-
ea ly AF ecu ence co ela ed wi h la e-blanking abla ion ou comes.
2. Me hods
2.1. S udy design
We pe o med a p ospec i e, single-cen e, longi udinal s udy ha
included consecu i e pa ien s unde going i s AF abla ion. Pa ien s
subjec ed o AF abla ion consis ed o adul s wi h symp oma ic pa ox-
ysmal o pe sis en AF. Acco ding o a p e iously published p o ocol,
PVI was pe o med using adio equency o c yoabla ion echniques.
[12]
The ea ly moni o ing app oach consis ed o applying he ePa ch on
he pa ien ’s ches du ing he i s 24 h a e PVI, a he momen o
discha ge, wi h a con inuous eco ding o 5 days - a maximum o 120 h
(Fig. 1). Subsequen ly, he occu ence o AF episodes was e alua ed
using an ex e nal 7-day loop eco de placed in he 2nd-mon h pos -
abla ion ( he la e blanking pe iod). In bo h de ices hea a e and R-R
a iabili y plo s we e eco ded and checked by he au oma ed so wa e
algo i hm. These acings we e hen e iewed by one echnician and
alida ed by a ca diology specialis in elec ophysiology. An ia -
hy hmic d ugs we e con inued h oughou he blanking pe iod wi h he
same dosages as p io o abla ion. AF ecu ence was de ined i a pe iod
o AF wi h >30 s was de ec ed in he ambula o y moni o ing, e alua ed
a a 3-mon h ollow-up appoin men .[1]
The p ima y ou come o he s udy was he co ela ion be ween AF
de ec ion in he e y-ea ly ( ia he ePa ch wea able) and he la e
blanking pe iod, e alua ed h ough he sensi i i y, speci ici y and p e-
dic i e a ios o e y-ea ly blanking AF de ec ion as a p edic o o la e-
blanking AF ecu ence. Seconda y ou comes included he e alua ion o
po en ial p edic o s o la e AF ecu ence ob ained om ePa ch da a
du ing he e y-ea ly blanking pe iod, namely he assessmen o s a is-
ical pa ame e s o hea a e a iabili y (HRV) – SDNN (NN s anda d
de ia ion o all eco ding), SDANN (NN s anda d de ia ion in all 5-min-
u e segmen s o he eco ding), RMSSD (squa e oo o mean o sum o
squa es o di e ences be ween adjacen NN in e als) and pNN50
(pe cen age o di e ences be ween adjacen no mal RR in e als ha
a e g ea e han 50 ms compu ed om he en i e eco ding). The ePa ch
ole abili y and e ec i eness in moni o ing hea hy hm o he s ipu-
la ed ime ame we e also e alua ed.
2.2. S a is ical analysis
Rele an da a ega ding popula ional cha ac e is ics, co-mo bidi ies
and pha maco he apy was collec ed be o e PVI. Con inuous a iables
we e epo ed as mean ±SD o median o IQR, depending on he da a
dis ibu ion pa e n. Ca ego ical da a we e depic ed as equencies and
pe cen ages. Di e ences be ween g oups we e calcula ed using Fishe ’s
exac es and he Wilcoxon ank-sum o ca ego ical and con inuous
da a, espec i ely. E alua ion o p edic o s o la e-blanking AF ecu -
ence was pe o med using uni a ia e logis ic eg ession models o
assess o in e ac ions be ween dependen and independen a iables.
Resea che s op ed no o pu sue mul i a ia e analysis gi en he low
sample size and o e all e en a e.[14,15]
Sensi i i y was de i ed h ough he a io o e y-ea ly ecu ence
and all la e-blanking pe iod ecu ences. Speci ici y was calcula ed by
di iding he numbe o no e y-ea ly ecu ences by he numbe o no
ecu ences. Posi i e and nega i e p edic i e alues (PPV/NPV) we e
de i ed om ou coho ’s es ima es o sensi i i y, speci ici y and disease
p e alence. A ecei e ope a o cha ac e is ic (ROC) cu e analysis was
pe o med o assess he co ela ion be ween he iming o e y-ea ly and
la e blanking pe iod ecu ences, wi h he calcula ion o he a ea unde
he cu e (AUC) assuming a non-pa ame ic model. Da a we e analyzed
Fig. 1. The E-pa ch; A – The E-pa ch de ice; B – Applica ion o he E-pa ch emo e moni o ing de ice on he ches wall o a pa ien .
M. Ma ques An unes e al.
IJC Hea & Vascula u e 51 (2024) 101369
3
using S a a® S a is ical So wa e Package, Ve sion 17.0 (S a aCo p LP,
College S a ion, Texas, EUA).
2.3. E hical conside a ions
The hospi al e hics commi ee app o ed he s udy p o ocol (E hics
Commi ee app o al numbe 974/2020). All pa icipan s p o ided
w i en in o med consen o da a collec ion, and he s udy was con-
duc ed acco ding o he Decla a ion o Helsinki guidelines.
3. Resul s
A o al o 48 pa ien s we e sc eened o en y in his p ospec i e
s udy, wi h a o al o 8 pa ien s no accep ing ea ly moni o ing wi h he
E-pa ch. Ou pa ien coho consis ed o a o al o 40 sequen ial pa ien s
ha we e included om No embe 2021 o Ma ch 2022. The median
pa ien age was 62 (IQR 56–70), wi h 16 (40 %) emales, p esen ing wi h
pa oxysmal AF (n =25, 62.5 %) and pe sis en AF (n =15, 37.5 %).
C yoabla ion was used in 17 cases (42.5 %) and adio equency in he
emaining pa icipan s. PVI was success ul in all he pa ien s, wi hou
pe ip ocedu al complica ions. The e we e no s a is ically signi ican
di e ences in he use o an ia hy hmic d ugs be ween pa ien g oups.
Gene al coho cha ac e is ics a e p esen ed in Table 1.
Rhy hm moni o ing wi h he ePa ch was ob ained o a median o
118 (IQR 112–120) hou s, wi h a minimum e ec i e moni o ing du a-
ion o 50 h. No discom o complain s in he use o he de ice no he
appea ance o in e p e a ion a e ac s we e egis e ed (Supplemen a y
Fig. 1). Ve y-ea ly AF ecu ence was de ec ed in 11 (27.5 %) pa ien s,
wi h a median AF bu den o 7 % (IQR 6 %–33 %). La e blanking pe iod
AF was de ec ed in 13 (33 %) o he ex e nal 7-day loop eco dings. Ou
o he 11 pa ien s ha had e y-ea ly AF ecu ence de ec ed in he
ePa ch moni o ing, 10 (91 %) main ained la e-blanking pe iods o AF.
Ve y-ea ly AF de ec ion showed a sensi i i y o 77 % (95 % CI 64
%-90 %) and a speci ici y o 96 % (95 % CI 90–100 %) in p edic ing la e-
blanking AF, wi h a PPV o 91 % (95 % CI 82 %-100 %) and a NPV o 90
% (95 % CI 80 %-100 %). A non-pa ame ic ROC cu e analysis de i ed
an AUC o 0.903 (95 % 0.797––1.0) (Fig. 2). Addi ionally, a non-
s a is ically signi ican end o highe HRV pa ame e s du ing he
ePa ch moni o ing was obse ed in pa ien s p esen ing wi h AF ecu -
ence du ing he la e blanking pe iod, wi h he pNN50 a iable (a
ma ke e lec ing he agal one) showing a signi ican alue in he
uni a ia e logis ic eg ession analysis (Table 2 and Supplemen a y
Table 2).
4. Discussion
Ou wo k ocused on he cha ac e iza ion o he e y-ea ly pe iod
ollowing PVI h ough con inuous ambula o y eco ding using a ake-
home wea able ECG-pa ch. In his pilo s udy, he ePa ch was well
ole a ed among all pa ien s and was able o de ec e y-ea ly AF, which
was highly p edic i e o la e-blanking AF ecu ence. While his inding
should be in e p e ed in he con ex o an unblinded s udy wi h a small
sample size, ou esul s emphasize he impo ance o he occu ence o
AF du ing he blanking in p edic ing la e AF e en s.[6,7,13] The new
da a is he ac ha e y-ea ly iden i ica ion o AF a e PVI has a high
p edic i e powe o la e-blanking pe iod AF ecu ence.
As p e iously men ioned, he e is cu en ly an open deba e ega ding
he du a ion o he blanking pe iod and i s ele ance o pa ien s and
clinical ou comes.[7,13] The median 7 % bu den o AF du ing he e y-
Table 1
Gene al pa ien cha ac e is ics s a i ied by la e-blanking ecu ence s a us.
Cha ac e is ics To al
pa ien s
(N =40)
Wi h la e
blanking AF
ecu ence (N
=27)
Wi hou la e
blanking AF
ecu ence (N
=13)
p-
alue
Age - y [IQR] 62 [70-
56]
59[70-57] 66 [70-55] 0.177
Female sex - n (%) 16 (40 %) 10 (37 %) 6 (46 %) 0.581
C yoabla ion – n (%) 17 (42.5
%)
13 (48 %) 4 (30 %) 0.298
BMI [IQR] 28[32-
24]
28[31-24] 29[33-25] 0.678
Pa oxysmal AF - n (%) 25 (62.5
%)
15 (55 %) 10 (77 %) 0.191
Pe sis en AF - n (%) 15 (37.5
%)
14 (52 %) 1 (8 %) 0.191
Hype ension - n (%) 22 (55 %) 15 (55 %) 7 (54 %) 0.919
Hype choles e olemia -
n (%)
18 (45 %) 14 (52 %) 4 (31 %) 0.207
Diabe es - n (%) 3 (7.5 %) 1 (4 %) 2 (16 %) 0.189
OSA - n (%) 4 (10 %) 2 (8 %) 2 (26 %) 0.431
Smoke - n (%) 6 (15 %) 5 (19 %) 1 (8 %) 0.369
CKD - n (%) 4 (10 %) 1 (4 %) 3 (23 %) 0.056
Thy oid disease - n (%) 9 (22.5
%)
6 (22 %) 3 (23 %) 0.952
Cance - n (%) 4 (10 %) 1 (4 %) 3 (23 %) 0.056
Hea Failu e - n (%) 9 (22.5
%)
6 (22 %) 3 (23 %) 0.952
Co ona y disease - n
(%)
2 (5 %) 1 (4 %) 1 (8 %) 0.588
Ischemic s oke - (%) 2 (5 %) 1 (4 %) 1 (8 %) 0.588
CHA2DS2-VASc [IQR] 2[3-1] 2[3-2] 2[2-1] 0.216
To al medica ion [IQR] 4 [5-3] 4[5-3] 4[6-3] 0.923
Be a-Blocke s – n (%) 32 (80 %) 23 (85 %) 9 (69 %) 0.237
Class I an ya y hmics –
n (%)
11 (27.5
%)
9 (33 %) 2 (16 %) 0.234
Class III an ya y hmics
– n (%)
5 (12.5
%)
4 (15 %) 1 (8 %) 0.523
Vi amin K an agonis –
n (%)
3 (7.5 %) 2 (8 %) 1 (8 %) 0.432
DOAC – n (%) 37 (93 %) 27 (93 %) 10 (91 %) 0.888
ACE-Inhibi o – n (%) 20 (50 %) 15 (55 %) 5 (38 %) 0.311
MRA – n (%) 5 (12.5
%)
4 (15 %) 1 (8 %) 0.505
AF – A ial ib illa ion AF; N – numbe ; y – yea s; SD – s anda d de ia ion; BMI –
body mass index, OSA – obs uc i e sleep apnea; CKD – ch onic kidney disease;
DOAC – di ec o al an icoagulan ; ACE – angio ensin-con e ing enzyme;
mine aloco icoid ecep o an agonis .
Fig. 2. Non-pa ame ic ROC cu e o he p edic i e e ec o e y-ea ly
blanking a ial ib illa ion ecu ence in p edic ing la e blanking a ial ib il-
la ion ecu ence wi h a calcula ed AUC o 0.903.
M. Ma ques An unes e al.
IJC Hea & Vascula u e 51 (2024) 101369
4
ea ly blanking pe iod obse ed in his s udy co esponds o app oxi-
ma ely 100 min o median daily AF, which ep esen s a signi ican
bu den, i e imes highe han he 23-minu e daily cu o poin , ha
ep esen ed a se en- old inc ease in he isk o AF a one-yea ollow-up
obse ed on a p io s udy om ou g oup’[7]. The ac ha mos pa ien s
showing e y-ea ly AF ecu ence had i wi h a signi ican a hy hmia
bu den may be in e p e ed as an indica o ha an AF bu den cu o can
be used in he u u e as a p edic o o AF ecu ence and clinical ou -
comes - bu u he s udies a e needed o alida e hese esul s.
La e de ec ion o AF ecu ence du ing he blanking pe iod has been
highly co ela ed wi h AF ecu ence.[13,14] A sub-analysis o he
DECAAF-II ial has indica ed ha a highe bu den o AF de ec ion
du ing he la e-blanking pe iod h ough an in e mi en eco ding wi h a
sma phone co ela ed wi h AF ecu ence a 90 days.[14] Addi ionally,
a sub-analysis o he ADVICE ial has showed ha a 1-yea ollow up,
compa ing o 23 % wi hou symp oma ic AF du ing he blanking pe iod,
92 % o pa ien s ha had symp oma ic AF du ing he la e blanking
pe iod had 1-yea ecu ence.[13] In bo h sub-analyses he de ec ion o
AF du ing he ea ly blanking pe iod also co ela ed – wi h less s eng h -
wi h pos -blanking AF ecu ence. The ac ha he e y ea ly blanking
pe iod was eco ded con inuously in ou pilo s udy may explain he
high a e o concomi an de ec ion and conco dance be ween e y-ea ly
and la e blanking pe iods. This e y-ea ly con inuous cha ac e iza ion
may lead o a be e isk s a i ica ion o AF ecu ence in he u u e.
Ea ly s udies on he blanking pe iod we e conduc ed in an e a in
which AF abla ion echnology h ough adio equency PVI and idi-
mensional mapping sys ems we e less de eloped. In ac , a highe deg ee
o subs a e changes and in lamma ion caused by adio equency ene gy
migh ha e been p oduced, yielding a highe a e o ea ly ecu ences
ha we e no sus ained in ime when compa ed o cu en indings.
[12,13] Albei no being powe ed o his pu pose, ou s udy ound no
signal o a p o ec i e e ec o c yoabla ion compa ed o adio equency
in ei he ea ly o la e AF ecu ence.
Sympa he ic ne ous sys em (SNS), pa icula ly he pa asympa he ic
ac i i y modula ion, has been conside ed as pa o he pos ula ed
bene i s o an al PVI – wi h he achie emen o pa asympa he ic
dene a ion in addi ion o PVI being sugges ed as a concu en an ia -
hy hmic mechanism, inc easing he success o AF abla ion. [12,15]
The indi ec assessmen o luc ua ions in SNS inpu s o he hea
h ough s a is ical measu es o HRV has been hea ily linked o clinical
ou comes, wi h highe alues o SDNN, RMSSD, and pNN50 being all
signi ican ly associa ed wi h an inc eased isk o AF.[16–18]
In ou s udy, highe HRV pa ame e s, ep esen ing excessi e au o-
nomic luc ua ions, appea ed o be linked wi h AF ecu ence a e PVI.
Howe e , hese indings ep esen a me e indica o o u u e s udies.
4.1. S udy limi a ions
The mos impo an limi a ions o ou s udy a e connec ed o i s
unblinded na u e, and he ac ha i was a single-cen e obse a ional
s udy, albei p ospec i e. The s udy coho consis ed exclusi ely o pa-
ien s unde going PVI abla ion, and submi ed bo h o an ea ly ePa ch
e alua ion and la e blanking pe iod ex e nal loop eco ding. The e o e,
i included a small selec ed popula ion. Also, HRV pa ame e s de i ed
om he ePa ch wea able de ice da a migh no be as alida ed as in he
s anda d 24 h Hol e eco ding. Howe e , ecen ly s udies used he
ePa ch o success ully moni o HRV in di e en clinical se ings.[19,20]
5. Conclusions
The E-Pa ch was able o de ec e y-ea ly AF du ing an ex ended
pe iod o ime. The occu ence o AF in he e y-ea ly moni o ing ap-
pea s o be signi ican ly p edic i e o la e blanking pe iod AF ecu ence
pos -abla ion. Also, highe HRV alues, e lec ing excessi e au onomic
luc ua ions, may be linked o an inc eased isk o la e blanking AF
episodes. Ou p elimina y indings need o be alida ed in la ge co-
ho s, p e e ably blinding o he ea ly eco ding esul s.
G an suppo .
This wo k did no ecei e any g an s.
E hical disclosu es.
P o ec ion o human and animal subjec s.
The au ho s decla e ha no expe imen s we e pe o med on humans
o animals o his s udy.
Con iden iali y o da a.
The au ho s decla e ha hey ha e ollowed he p o ocols o hei
wo k cen e on he publica ion o pa ien da a.
Righ o p i acy and in o med consen .
The au ho s decla e ha no pa ien da a appea in his a icle.
CRediT au ho ship con ibu ion s a emen
Miguel Ma ques An unes: W i ing – e iew & edi ing, W i ing –
o iginal d a , Visualiza ion, Valida ion, Supe ision, So wa e, Re-
sou ces, P ojec adminis a ion, Me hodology, In es iga ion, Fo mal
analysis, Da a cu a ion, Concep ualiza ion. Ped o Sil a Cunha: W i ing
– e iew & edi ing, W i ing – o iginal d a , Valida ion, Supe ision,
Resou ces, P ojec adminis a ion, Me hodology, In es iga ion, Fo mal
analysis, Da a cu a ion, Concep ualiza ion. B´
a ba a Lace da Teixei a:
W i ing – o iginal d a , Valida ion, So wa e, Da a cu a ion. Guilhe me
Po ugal: W i ing – e iew & edi ing, In es iga ion, Fo mal analysis,
Da a cu a ion, Concep ualiza ion. B uno Valen e: W i ing – o iginal
d a , Valida ion, P ojec adminis a ion, Fo mal analysis, Concep uali-
za ion. Ana Lousinha: W i ing – e iew & edi ing, P ojec adminis a-
ion, In es iga ion, Fo mal analysis, Da a cu a ion. Ana So ia Delgado:
. Sand a Al es: Valida ion, P ojec adminis a ion, Me hodology,
In es iga ion, Fo mal analysis, Da a cu a ion. C´
a ia Gue a: Valida ion,
So wa e, Resou ces, P ojec adminis a ion, Fo mal analysis, Da a
cu a ion. Rui C uz Fe ei a: W i ing – e iew & edi ing, Visualiza ion,
Table 2
Epa ch moni o ing da a s a i ied by la e-blanking ecu ence o a ial
ib illa ion.
Cha ac e is ics To al
pa ien s
(N =40)
wi h la e
blanking AF
ecu ence (N =
27)
wi hou la e
blanking AF
ecu ence (N =
13)
p-
alue
Moni o ing ime -
hou s [IQR]
118[120-
113]
118[120-112] 117[120-113] 0.912
A e age HR -
[IQR]
66[72-60] 65[71-58] 70[75-60] 0.219
Maximum HR -
[IQR]
113[123-
101]
112[132-100] 116[170-108] 0.318
Minimum HR -
[IQR]
49[55-38] 49[55-42] 49[53-34] 0.410
SVE – n [IQR] 1544
[5666-
181]
1289[6089-
132]
3480[52431403] 0.114
Isola ed SVE – n
[IQR]
1390
[5273]
1089[6089-
132]
2535[5199-
1397]
0.144
NN a e age - ms
[IQR]
917[975-
838]
922[1036-875] 870[967-750] 0.143
SDNN - ms [IQR] 121[165-
97]
121[142-98] 160[228-85] 0.405
SDANN – ms
[IQR]
101[120-
82]
101[110-85] 102[166-74] 0.670
RMSSD – ms
[IQR]
47[76-37] 48[57-39] 45[94-26] 0.810
pNN >50 % -
[IQR]
8 %[21-4] 7 % [12 %-4%] 15 % [44 %-4%] 0.285
AF – A ial ib illa ion AF; HR – hea a e; N – numbe ; y – yea s; SD – s anda d
de ia ion; SVE – Sup a en icula Ec opy; NN - no mal o no mal in e al; SDNN
– NN s anda d de ia ion in all eco ding; SDANN – NN s anda d de ia ion in all
5-minu e segmen s o he eco ding; RMSDD - Squa e oo o mean o sum o
squa es o di e ences be ween adjacen NN in e als; pNN50 - Pe cen o di -
e ences be ween adjacen no mal RR in e als ha a e g ea e han 50 ms
compu ed o e he en i e eco ding.
M. Ma ques An unes e al.
IJC Hea & Vascula u e 51 (2024) 101369
5
Valida ion, Supe ision, Resou ces, Me hodology, Concep ualiza ion.
M´
a io Ma ins Oli ei a: W i ing – e iew & edi ing, W i ing – o iginal
d a , Visualiza ion, Valida ion, Supe ision, Resou ces, Me hodology,
In es iga ion, Fo mal analysis, Concep ualiza ion.
Decla a ion o compe ing in e es
The au ho s decla e ha hey ha e no known compe ing inancial
in e es s o pe sonal ela ionships ha could ha e appea ed o in luence
he wo k epo ed in his pape .
Acknowledgemen s
None o decla e.
Appendix A. Supplemen a y da a
Supplemen a y da a o his a icle can be ound online a h ps://doi.
o g/10.1016/j.ijcha.2024.101369.
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