{"doi":"10.1016/j.cvdhj.2023.06.004","title":"Episodes of Atrial Fibrillation and Symptoms: A Temporal Analysis","abstract":"BackgroundData on the relationship between symptoms and atrial fibrillation (AF) episodes are limited.ObjectiveThe objective of this study was to determine the strength of temporal association between AF episodes and symptoms.MethodsThis cross-sectional ambulatory assessment study was performed in a tertiary care center between 06/2018 and 12/2021. Patients with paroxysmal AF (one episode of AF, burden not exceeding 95%) who used a mobile application and continuous wearable ECG monitor for 21 days were enrolled. The primary outcome was worse symptoms (symptoms above the mean score) over the study period. The association between worse symptoms and the presence of AF was evaluated for different time epochs. Multilevel mixed effect models were used to quantify associations after accounting for confounders.ResultsWorse symptoms were more likely to be associated with the presence of AF episodes 15 minutes prior to the reporting of palpitations (Odds ratio [OR], 2.8 [ 95% CI, 1.6–5.0]; P< 0.001 ), shortness of breath (OR, 2.2 [95% CI, 1.3–3.7]; P=0.003), dizziness/light-headedness (OR, 2.0 [95% CI, 1.0–3.7]; P=0.04), and fatigue (OR, 1.7 [95% CI,1.0–2.9]; P=0.03). The correlation between the severity of symptoms and AF lessened as the time interval from AF events to symptoms increased.ConclusionThere is a significant relationship between onset of AF episodes and reporting of symptoms. This association diminishes over time and varies across different symptoms. If confirmed in larger studies, these findings may inform AF interventions that target symptoms just in time prior to a clinical visit. Data on the relationship between symptoms and atrial fibrillation (AF) episodes are limited. The objective of this study was to determine the strength of temporal association between AF episodes and symptoms. This cross-sectional ambulatory assessment study was performed in a tertiary care center between 06/2018 and 12/2021. Patients with paroxysmal AF (one episode of AF, burden not exceeding 95%) who used a mobile application and continuous wearable ECG monitor for 21 days were enrolled. The primary outcome was worse symptoms (symptoms above the mean score) over the study period. The association between worse symptoms and the presence of AF was evaluated for different time epochs. Multilevel mixed effect models were used to quantify associations after accounting for confounders. Worse symptoms were more likely to be associated with the presence of AF episodes 15 minutes prior to the reporting of palpitations (Odds ratio [OR], 2.8 [ 95% CI, 1.6–5.0]; P< 0.001 ), shortness of breath (OR, 2.2 [95% CI, 1.3–3.7]; P=0.003), dizziness/light-headedness (OR, 2.0 [95% CI, 1.0–3.7]; P=0.04), and fatigue (OR, 1.7 [95% CI,1.0–2.9]; P=0.03). The correlation between the severity of symptoms and AF lessened as the time interval from AF events to symptoms increased. There is a significant relationship between onset of AF episodes and reporting of symptoms. This association diminishes over time and varies across different symptoms. If confirmed in larger studies, these findings may inform AF interventions that target symptoms just in time prior to a clinical visit.","journal":"Cardiovascular Digital Health Journal","year":2023,"id":385134,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":2,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9373,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2023-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":328072,"name":"Daniel Whibley","orcid":"0000-0002-7131-7158","position":1,"is_corresponding":false},{"id":404382,"name":"H. Immo Lehmann","orcid":"0000-0003-4379-283X","position":2,"is_corresponding":false},{"id":1152881,"name":"Zhi Li","orcid":"0000-0003-2674-8255","position":3,"is_corresponding":false},{"id":328071,"name":"Anna L. Kratz","orcid":"0000-0002-3664-3898","position":4,"is_corresponding":false},{"id":270290,"name":"Daniel J. Clauw","orcid":"0000-0002-8114-7818","position":5,"is_corresponding":false},{"id":240113,"name":"Brahmajee K. Nallamothu","orcid":"0000-0003-4331-6649","position":6,"is_corresponding":false},{"id":782597,"name":"Hamid Ghanbari","orcid":"0009-0004-7826-4740","position":0,"is_corresponding":true}],"reference_count":11,"raw_metadata":null,"created_at":"2026-07-19T01:17:48.629718Z","pmid":"37850044","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}