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Improving Stroke Risk Stratification Using the CHADS 2 and CHA 2 DS 2 -VASc Risk Scores in Patients With Paroxysmal Atrial Fibrillation by Continuous Arrhythmia Burden Monitoring

Open access
Boriani, Giuseppe, Botto, Giovanni Luca, Padeletti, Luigi, Santini, Massimo, Capucci, Alessandro, Gulizia, Michele, Ricci, Renato, Biffi, Mauro, De Santo, Tiziana, Corbucci, Giorgio, Lip, Gregory Y.H., for the Italian AT-500 Registry Investigators·2011·Stroke

Abstract

Background and Purpose—: In patients with atrial fibrillation (AF), stroke risk stratification schema do not consider AF parameters. The aim of the study is to assess the impact of combining risk factors with continuous AF burden monitoring. Methods—: In this retrospective study 568 patients implanted with a DDDR-P pacemaker (AT-500; Medtronic) and a history of AF were continuously monitored for 1 year. Results—: During follow-up, 14 patients (2.5%) had a thromboembolic event. Patients were divided into 3 groups: AF burden ≤5 minutes per day (AF-free; n=223 [39%]), AF burden >5 minutes but <24 hours per day (AF-5 minutes; n=179 [32%]), and AF burden ≥24 hours (AF-24 hours; n=166 [29%]). Patients were also classified according to CHADS 2 and CHA 2 DS 2 -VASc risk scores. The discrimination ability of each risk score was evaluated performing a logistic regression analysis and calculating the corresponding C-statistic. The addition of AF burden improved C-statistics: for CHADS 2 from 0.653 ( P =0.051) to 0.713 ( P =0.007); for CHA 2 DS 2 -VASc, from 0.898 ( P <0.0001) to 0.910 ( P <0.0001). Conclusions—: The CHA 2 DS 2 -VASc score had a high sensitivity to predict thromboembolism. Implementation of device data on AF presence/duration/burden has the potential to contribute to improved clinical risk stratification and should be tested prospectively.

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Crossref · 10.1161/strokeaha.110.609297

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Metadata

Authors
Boriani, G., Botto, G. L., Padeletti, L., Santini, M., Capucci, A., Gulizia, M., Ricci, R., Biffi, M., De Santo, T., Corbucci, G., Lip, G. Y. H., & for the Italian AT-500 Registry Investigators
Venue
Stroke
Published
2011-06
Volume
42
Issue
6
Pages
1768-1770
ISSN
  • 0039-2499 (ISSN-L)
  • 1524-4628
OpenAlex
W2151550586
Cited by
183
References
2
FWCI
16.00
Type
journal article
Language
en
Open access
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CoChat. (2026). Citation check: Improving Stroke Risk Stratification Using the CHADS 2 and CHA 2 DS 2 -VASc Risk Scores in Patients With Paroxysmal Atrial Fibrillation by Continuous Arrhythmia Burden Monitoring. https://app.cochat.ai/papers/10.1161/strokeaha.110.609297
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Boriani, G., Botto, G. L., Padeletti, L., Santini, M., Capucci, A., Gulizia, M., Ricci, R., Biffi, M., De Santo, T., Corbucci, G., Lip, G. Y. H., & for the Italian AT-500 Registry Investigators. (2011). Improving Stroke Risk Stratification Using the CHADS 2 and CHA 2 DS 2 -VASc Risk Scores in Patients With Paroxysmal Atrial Fibrillation by Continuous Arrhythmia Burden Monitoring. Stroke. https://doi.org/10.1161/strokeaha.110.609297

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Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).

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