array:26 [
  "pii" => "S2174204917302076"
  "issn" => "21742049"
  "doi" => "10.1016/j.repce.2016.12.020"
  "estado" => "S300"
  "fechaPublicacion" => "2017-07-01"
  "aid" => "1030"
  "copyright" => "Sociedade Portuguesa de Cardiologia"
  "copyrightAnyo" => "2017"
  "documento" => "simple-article"
  "crossmark" => 1
  "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
  "subdocumento" => "dis"
  "cita" => "Rev Port Cardiol. 2017;36:547-9"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:2 [
    "total" => 1807
    "formatos" => array:3 [
      "EPUB" => 163
      "HTML" => 1321
      "PDF" => 323
    ]
  ]
  "Traduccion" => array:1 [
    "en" => array:20 [
      "pii" => "S0870255116303821"
      "issn" => "08702551"
      "doi" => "10.1016/j.repc.2016.12.011"
      "estado" => "S300"
      "fechaPublicacion" => "2017-07-01"
      "aid" => "1030"
      "copyright" => "Sociedade Portuguesa de Cardiologia"
      "documento" => "simple-article"
      "crossmark" => 1
      "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
      "subdocumento" => "dis"
      "cita" => "Rev Port Cardiol. 2017;36:547-9"
      "abierto" => array:3 [
        "ES" => true
        "ES2" => true
        "LATM" => true
      ]
      "gratuito" => true
      "lecturas" => array:2 [
        "total" => 2405
        "formatos" => array:3 [
          "EPUB" => 188
          "HTML" => 1766
          "PDF" => 451
        ]
      ]
      "en" => array:10 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">Editorial comment</span>"
        "titulo" => "Atrial fibrillation monitoring to reduce thromboembolic risk&#58; Selecting the patient and the monitoring device"
        "tienePdf" => "en"
        "tieneTextoCompleto" => "en"
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "547"
            "paginaFinal" => "549"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "pt" => array:1 [
            "titulo" => "Monitoriza&#231;&#227;o eletrocardiogr&#225;fica para a redu&#231;&#227;o do risco tromboemb&#243;lico&#58; sele&#231;&#227;o do doente e do dispositivo de monitoriza&#231;&#227;o"
          ]
        ]
        "contieneTextoCompleto" => array:1 [
          "en" => true
        ]
        "contienePdf" => array:1 [
          "en" => true
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "S&#233;rgio Barra, Rui Provid&#234;ncia"
            "autores" => array:2 [
              0 => array:2 [
                "nombre" => "S&#233;rgio"
                "apellidos" => "Barra"
              ]
              1 => array:2 [
                "nombre" => "Rui"
                "apellidos" => "Provid&#234;ncia"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "en"
      "Traduccion" => array:1 [
        "en" => array:9 [
          "pii" => "S2174204917302076"
          "doi" => "10.1016/j.repce.2016.12.020"
          "estado" => "S300"
          "subdocumento" => ""
          "abierto" => array:3 [
            "ES" => true
            "ES2" => true
            "LATM" => true
          ]
          "gratuito" => true
          "lecturas" => array:1 [
            "total" => 0
          ]
          "idiomaDefecto" => "en"
          "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2174204917302076?idApp=UINPBA00004E"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0870255116303821?idApp=UINPBA00004E"
      "url" => "/08702551/0000003600000078/v1_201707241250/S0870255116303821/v1_201707241250/en/main.assets"
    ]
  ]
  "itemSiguiente" => array:20 [
    "pii" => "S2174204917302088"
    "issn" => "21742049"
    "doi" => "10.1016/j.repce.2017.05.008"
    "estado" => "S300"
    "fechaPublicacion" => "2017-07-01"
    "aid" => "1025"
    "copyright" => "Sociedade Portuguesa de Cardiologia"
    "documento" => "article"
    "crossmark" => 1
    "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
    "subdocumento" => "rev"
    "cita" => "Rev Port Cardiol. 2017;36:551-67"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 8347
      "formatos" => array:3 [
        "EPUB" => 240
        "HTML" => 7460
        "PDF" => 647
      ]
    ]
    "en" => array:13 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Review Article</span>"
      "titulo" => "Aspirin and blood pressure&#58; Effects when used alone or in combination with antihypertensive drugs"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "pt"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "551"
          "paginaFinal" => "567"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "pt" => array:1 [
          "titulo" => "Aspirina e press&#227;o arterial&#58; efeitos do uso isolado ou em associa&#231;&#227;o com f&#225;rmacos anti-hipertensores"
        ]
      ]
      "contieneResumen" => array:2 [
        "en" => true
        "pt" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig0015"
          "etiqueta" => "Figure 3"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr3.jpeg"
              "Alto" => 2415
              "Ancho" => 3000
              "Tamanyo" => 447467
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Major protective effects of low-dose aspirin&#46; AA&#58; arachidonic acid&#59; ATL&#58; aspirin-triggered lipoxin&#59; COX-1&#58; cyclooxygenase-1&#59; COX-2&#58; cyclooxygenase-2&#59; eNOS&#58; endothelial nitric oxide synthase&#59; NO&#58; nitric oxide&#59; PD&#58; protectin&#59; Rvs&#58; resolvins&#59; TXA<span class="elsevierStyleInf">2</span>&#58; thromboxane A<span class="elsevierStyleInf">2</span>&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Ana Catarina Costa, Marta Reina-Couto, Ant&#243;nio Albino-Teixeira, Teresa Sousa"
          "autores" => array:4 [
            0 => array:2 [
              "nombre" => "Ana Catarina"
              "apellidos" => "Costa"
            ]
            1 => array:2 [
              "nombre" => "Marta"
              "apellidos" => "Reina-Couto"
            ]
            2 => array:2 [
              "nombre" => "Ant&#243;nio"
              "apellidos" => "Albino-Teixeira"
            ]
            3 => array:2 [
              "nombre" => "Teresa"
              "apellidos" => "Sousa"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "en" => array:9 [
        "pii" => "S0870255117302895"
        "doi" => "10.1016/j.repc.2017.05.008"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => true
          "ES2" => true
          "LATM" => true
        ]
        "gratuito" => true
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "en"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0870255117302895?idApp=UINPBA00004E"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2174204917302088?idApp=UINPBA00004E"
    "url" => "/21742049/0000003600000078/v1_201707290050/S2174204917302088/v1_201707290050/en/main.assets"
  ]
  "itemAnterior" => array:20 [
    "pii" => "S217420491730199X"
    "issn" => "21742049"
    "doi" => "10.1016/j.repce.2016.11.013"
    "estado" => "S300"
    "fechaPublicacion" => "2017-07-01"
    "aid" => "964"
    "copyright" => "Sociedade Portuguesa de Cardiologia"
    "documento" => "article"
    "crossmark" => 1
    "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
    "subdocumento" => "fla"
    "cita" => "Rev Port Cardiol. 2017;36:535-46"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 3002
      "formatos" => array:3 [
        "EPUB" => 162
        "HTML" => 2357
        "PDF" => 483
      ]
    ]
    "en" => array:12 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Original Article</span>"
      "titulo" => "Prevalence of paroxysmal atrial fibrillation in a population assessed by continuous 24-hour monitoring"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "pt"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "535"
          "paginaFinal" => "546"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "pt" => array:1 [
          "titulo" => "Preval&#234;ncia da fibrilha&#231;&#227;o auricular parox&#237;stica numa popula&#231;&#227;o avaliada por monitoriza&#231;&#227;o cont&#237;nua de 24 horas"
        ]
      ]
      "contieneResumen" => array:2 [
        "en" => true
        "pt" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Jo&#227;o Primo, Helena Gon&#231;alves, Ana Macedo, Paula Russo, Telma Monteiro, Jo&#227;o Guimar&#227;es, Ovidio Costa"
          "autores" => array:7 [
            0 => array:2 [
              "nombre" => "Jo&#227;o"
              "apellidos" => "Primo"
            ]
            1 => array:2 [
              "nombre" => "Helena"
              "apellidos" => "Gon&#231;alves"
            ]
            2 => array:2 [
              "nombre" => "Ana"
              "apellidos" => "Macedo"
            ]
            3 => array:2 [
              "nombre" => "Paula"
              "apellidos" => "Russo"
            ]
            4 => array:2 [
              "nombre" => "Telma"
              "apellidos" => "Monteiro"
            ]
            5 => array:2 [
              "nombre" => "Jo&#227;o"
              "apellidos" => "Guimar&#227;es"
            ]
            6 => array:2 [
              "nombre" => "Ovidio"
              "apellidos" => "Costa"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "pt" => array:9 [
        "pii" => "S0870255117301270"
        "doi" => "10.1016/j.repc.2016.11.005"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => true
          "ES2" => true
          "LATM" => true
        ]
        "gratuito" => true
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "pt"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0870255117301270?idApp=UINPBA00004E"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S217420491730199X?idApp=UINPBA00004E"
    "url" => "/21742049/0000003600000078/v1_201707290050/S217420491730199X/v1_201707290050/en/main.assets"
  ]
  "asociados" => array:1 [
    0 => array:20 [
      "pii" => "S217420491730199X"
      "issn" => "21742049"
      "doi" => "10.1016/j.repce.2016.11.013"
      "estado" => "S300"
      "fechaPublicacion" => "2017-07-01"
      "aid" => "964"
      "copyright" => "Sociedade Portuguesa de Cardiologia"
      "documento" => "article"
      "crossmark" => 1
      "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
      "subdocumento" => "fla"
      "cita" => "Rev Port Cardiol. 2017;36:535-46"
      "abierto" => array:3 [
        "ES" => true
        "ES2" => true
        "LATM" => true
      ]
      "gratuito" => true
      "lecturas" => array:2 [
        "total" => 3002
        "formatos" => array:3 [
          "EPUB" => 162
          "HTML" => 2357
          "PDF" => 483
        ]
      ]
      "en" => array:12 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">Original Article</span>"
        "titulo" => "Prevalence of paroxysmal atrial fibrillation in a population assessed by continuous 24-hour monitoring"
        "tienePdf" => "en"
        "tieneTextoCompleto" => "en"
        "tieneResumen" => array:2 [
          0 => "en"
          1 => "pt"
        ]
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "535"
            "paginaFinal" => "546"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "pt" => array:1 [
            "titulo" => "Preval&#234;ncia da fibrilha&#231;&#227;o auricular parox&#237;stica numa popula&#231;&#227;o avaliada por monitoriza&#231;&#227;o cont&#237;nua de 24 horas"
          ]
        ]
        "contieneResumen" => array:2 [
          "en" => true
          "pt" => true
        ]
        "contieneTextoCompleto" => array:1 [
          "en" => true
        ]
        "contienePdf" => array:1 [
          "en" => true
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "Jo&#227;o Primo, Helena Gon&#231;alves, Ana Macedo, Paula Russo, Telma Monteiro, Jo&#227;o Guimar&#227;es, Ovidio Costa"
            "autores" => array:7 [
              0 => array:2 [
                "nombre" => "Jo&#227;o"
                "apellidos" => "Primo"
              ]
              1 => array:2 [
                "nombre" => "Helena"
                "apellidos" => "Gon&#231;alves"
              ]
              2 => array:2 [
                "nombre" => "Ana"
                "apellidos" => "Macedo"
              ]
              3 => array:2 [
                "nombre" => "Paula"
                "apellidos" => "Russo"
              ]
              4 => array:2 [
                "nombre" => "Telma"
                "apellidos" => "Monteiro"
              ]
              5 => array:2 [
                "nombre" => "Jo&#227;o"
                "apellidos" => "Guimar&#227;es"
              ]
              6 => array:2 [
                "nombre" => "Ovidio"
                "apellidos" => "Costa"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "en"
      "Traduccion" => array:1 [
        "pt" => array:9 [
          "pii" => "S0870255117301270"
          "doi" => "10.1016/j.repc.2016.11.005"
          "estado" => "S300"
          "subdocumento" => ""
          "abierto" => array:3 [
            "ES" => true
            "ES2" => true
            "LATM" => true
          ]
          "gratuito" => true
          "lecturas" => array:1 [
            "total" => 0
          ]
          "idiomaDefecto" => "pt"
          "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0870255117301270?idApp=UINPBA00004E"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S217420491730199X?idApp=UINPBA00004E"
      "url" => "/21742049/0000003600000078/v1_201707290050/S217420491730199X/v1_201707290050/en/main.assets"
    ]
  ]
  "en" => array:12 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Editorial comment</span>"
    "titulo" => "Atrial fibrillation monitoring to reduce thromboembolic risk&#58; Selecting the patient and the monitoring device"
    "tieneTextoCompleto" => true
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "547"
        "paginaFinal" => "549"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "S&#233;rgio Barra, Rui Provid&#234;ncia"
        "autores" => array:2 [
          0 => array:4 [
            "nombre" => "S&#233;rgio"
            "apellidos" => "Barra"
            "email" => array:1 [
              0 => "sergioncbarra&#64;gmail&#46;com"
            ]
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">&#42;</span>"
                "identificador" => "cor0005"
              ]
            ]
          ]
          1 => array:3 [
            "nombre" => "Rui"
            "apellidos" => "Provid&#234;ncia"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:2 [
          0 => array:3 [
            "entidad" => "Cardiology Department&#44; Papworth Hospital NHS Foundation Trust&#44; Cambridge&#44; UK"
            "etiqueta" => "a"
            "identificador" => "aff0005"
          ]
          1 => array:3 [
            "entidad" => "Barts Heart Centre&#44; Barts Health NHS Trust&#44; London&#44; UK"
            "etiqueta" => "b"
            "identificador" => "aff0010"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Corresponding author&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "pt" => array:1 [
        "titulo" => "Monitoriza&#231;&#227;o eletrocardiogr&#225;fica para a redu&#231;&#227;o do risco tromboemb&#243;lico&#58; sele&#231;&#227;o do doente e do dispositivo de monitoriza&#231;&#227;o"
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Atrial fibrillation &#40;AF&#41; is the most common sustained cardiac arrhythmia and is associated with a five-fold increased risk of stroke&#46; At least 15-20&#37; of strokes are attributed to underlying AF&#44; but subclinical AF may be the cause of an additional number of cerebrovascular events&#46; Data from cardiac implantable electronic devices &#40;CIEDs&#41; have shown that subclinical atrial tachyarrhythmias lasting more than six minutes are associated with increased risk of thromboembolism&#46;<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">1</span></a> The often silent and intermittent nature of AF poses a problem&#59; more than half of AF episodes are asymptomatic<a class="elsevierStyleCrossRefs" href="#bib0090"><span class="elsevierStyleSup">2&#44;3</span></a> and therefore identifying patients at risk remains a challenge&#46; This is a good illustration of the importance of AF monitoring&#46; Continuous monitoring with implantable cardiac monitors is now widely used in patients with cryptogenic stroke to identify those with silent AF who warrant antithrombotic therapy&#46;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">4</span></a> In this context&#44; the prevalence of AF is approximately 20&#37;&#46; Stroke guidelines state that prolonged rhythm monitoring for AF of approximately 30 days is reasonable within six months of a cerebrovascular event with no apparent cause&#46;<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">5</span></a> In addition to risk stratification for stroke prevention&#44; AF monitoring and detection is also useful to assess the efficacy of rhythm control strategies&#44; prevent inappropriate shocks in implantable cardioverter-defibrillator &#40;ICD&#41; patients and maximize the benefit of cardiac resynchronization therapy &#40;CRT&#41;&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">Detection of subclinical atrial tachyarrhythmias can be performed through a variety of tools&#44; including external surface monitoring with intermittent 12-lead electrocardiogram&#44; ambulatory Holter monitors&#44; cardiac event recorders&#44; portable electrocardiogram recorders &#40;such as AliveCor&#41; and the more recent adhesive patch electrocardiographic monitors&#44; as well as CIEDs such as implantable loop recorders&#44; dual-chamber pacemakers or ICDs and CRT devices&#46; Although longer-term Holter and event recorders have superior diagnostic yield compared to intermittent 12-lead ECGs&#44;<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">6</span></a> the need for a transmitter device and lower patient compliance represent limitations&#46; Patient compliance diminishes as the nominal monitoring duration increases&#44; owing to concerns regarding skin irritation and the inconvenience of performing daily activities while wearing a monitor&#46; More recent methods include simpler patch-type monitors which provide instant feedback and may lead to immediate changes in medical management&#46; In patients with CIEDs&#44; the possibility of continuous long-term monitoring increases the monitoring sensitivity&#46; In the setting of post-cryptogenic stroke&#44; long-term continuous monitoring with an implantable cardiac monitor has been shown to be superior in detecting AF to any intermittent monitoring strategy&#46;<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">7</span></a> However&#44; their applicability is hampered by the need for an invasive procedure&#46; Ideally&#44; the optimal monitoring device should be non-invasive&#44; inexpensive&#44; simple to use and able to provide continuous long-term monitoring with immediate feedback&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">In this issue of the <span class="elsevierStyleItalic">Journal</span>&#44; Primo et al&#46; have elegantly provided an assessment of the prevalence of AF&#44; based on episodes of atrial arrhythmia lasting for more than 30 seconds&#44; obtained through a 12-lead Holter monitor&#46;<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">8</span></a> Their study cohort included patients referred for Holter monitoring for a variety of reasons&#44; as determined by their general practitioners&#46; The main strengths of this study are &#40;1&#41; its prospective nature&#44; &#40;2&#41; the use of 12-lead electrocardiographic monitoring&#44; which enables more accurate determination of the underlying rhythm &#40;with potential therapeutic implications&#41; compared to the standard three-lead Holter&#44; &#40;3&#41; continuous 24-hour monitoring&#44; as opposed to a single 12-lead ECG as used in the FAMA study&#44;<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">9</span></a> with improved diagnostic yield&#44; &#40;4&#41; the inclusion of a relatively unbiased population of patients seen due to a variety of cardiovascular symptoms&#44; enabling a more accurate representation of AF prevalence in this context&#44; &#40;5&#41; an independent and blinded analysis by up to three different electrophysiologists&#44; and &#40;6&#41; the large size of the study sample&#44; allowing narrow 95&#37; confidence intervals&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">Several important observations can be made on the results of this study&#46; Firstly&#44; more than 10 out of 100 patients participating in this study had documented AF or atrial flutter &#40;of which one fifth with paroxysmal AF&#41;&#46; This figure is higher than previously reported in both European and American studies&#44;<a class="elsevierStyleCrossRefs" href="#bib0130"><span class="elsevierStyleSup">10&#44;11</span></a> although AF prevalence in individuals aged 80 years or older may indeed be well above 10&#37;&#46;<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">10</span></a> In 2010&#44; the number of adults aged &#8805;55 years with AF corresponded to 1&#46;8&#37; of the total European Union population&#44; and this figure will rise to 3&#46;5&#37; by 2060&#46; This increase will be particularly dramatic in adults aged over 75&#46;<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">12</span></a> The higher prevalence of AF in the present study is likely a result of the criteria used for patient selection&#46; A higher AF prevalence should be expected in patients who present with cardiovascular symptoms&#44; even if non-specific&#44; compared to a cohort of asymptomatic patients&#46; However&#44; this study does provide us with a reasonably accurate estimate of AF prevalence among symptomatic patients who are typically seen by their general practitioners&#46; The number may be higher in the context of a more specialized cardiology outpatient clinic&#46; It is also noteworthy that advances in treatment for chronic cardiac and non-cardiac conditions&#44; aging populations&#44; and improved ability to diagnose AF through a wider range of monitoring devices may explain the higher prevalence of AF in more recent studies compared with older ones&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">Secondly&#44; the vast majority of patients with documented paroxysmal AF had never had any ECG documentation of this arrhythmia and hence only a minority of these were anticoagulated&#46; As the authors state&#44; the very low use of anticoagulation is mainly a reflection of an undiagnosed cohort&#44; although faulty judgments on the risk of bleeding&#44; especially in elderly patients&#44; also help explain the low rate of anticoagulation prescription in AF patients&#44; as shown in the Portuguese setting&#46;<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">13</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">In patients with cardiovascular symptoms&#44; manual pulse palpation should be performed to determine the presence of an irregular pulse that could indicate underlying AF&#46; A 12-lead electrocardiogram should then be performed on all patients in whom a diagnosis of AF is suspected based on the detection of an irregular pulse&#46; The present study demonstrates that 24-hour Holter should also be considered for all of these patients&#44; with consideration of longer monitoring in patients whose characteristics may put them at higher risk of AF&#58; male gender&#44; advanced age&#44; or a history of hypertension&#44; chronic obstructive pulmonary disease&#44; cerebrovascular or ischemic heart disease&#46; Likewise&#44; a large waist circumference&#44; sedentary lifestyle and high alcohol intake are also predictors of AF&#46; Young age should not preclude appropriate investigation&#44; as AF is seen throughout all age strata&#44; as this study shows&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Notwithstanding the unequivocal merit of this study&#44; we should point out that&#44; in patients considered to be at high risk of AF&#44; and especially those who have sustained a cerebrovascular event&#44; 24-hour Holter monitoring may be insufficient&#46; It is well established that the longer a patient is monitored &#40;and this is not exclusive to implantable cardiac monitors&#41;&#44; the greater the likelihood of detecting sustained atrial arrhythmias including asymptomatic AF&#44; with subsequent impact on the rate of anticoagulation prescription&#46;<a class="elsevierStyleCrossRefs" href="#bib0150"><span class="elsevierStyleSup">14&#44;15</span></a></p><p id="par0040" class="elsevierStylePara elsevierViewall">The role of AF monitoring for the selection of patients who could benefit from catheter ablation is much less straightforward&#46; AF ablation is mostly indicated in symptomatic patients for quality-of-life purposes&#46; AF ablation in asymptomatic patients is not generally recommended&#44; and this is unlikely to change in the near future unless studies such as the Catheter Ablation Versus Antiarrhythmic Drug Therapy for Atrial Fibrillation &#40;CABANA&#41; trial demonstrate that successful AF ablation can lead to decreased long-term risk of mortality or stroke compared with medical management&#46; Despite promising results by Di Biase et al&#46; in a recent study of heart failure patients with AF&#44;<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">16</span></a> all other evidence supporting the utility of AF ablation in stroke or mortality risk reduction is based on observational data&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">To summarize&#44; 24-hour 12-lead Holter monitors are an elegant screening method for patients with a multitude of cardiovascular symptoms&#44; enabling detection of paroxysmal AF or atrial flutter in a non-negligible percentage of patients&#46; In patients with risk factors for AF and especially a recent history of thromboembolism&#44; more prolonged or long-term continuous AF monitoring should be performed wherever possible&#46; Even short-lasting atrial arrhythmias carry a significantly increased risk of thromboembolism and therefore any documented AF of at least a few minutes should lead to consideration of oral anticoagulation prophylaxis as per the CHA<span class="elsevierStyleInf">2</span>DS<span class="elsevierStyleInf">2</span>-VASc score&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflicts of interest</span><p id="par0050" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interest to declare&#46;</p></span></span>"
    "textoCompletoSecciones" => array:1 [
      "secciones" => array:2 [
        0 => array:2 [
          "identificador" => "sec0005"
          "titulo" => "Conflicts of interest"
        ]
        1 => array:1 [
          "titulo" => "References"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0005"
          "bibliografiaReferencia" => array:16 [
            0 => array:3 [
              "identificador" => "bib0085"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Subclinical atrial fibrillation and the risk of stroke"
                      "autores" => array:1 [
                        0 => array:3 [
                          "colaboracion" => "ASSERT Investigators"
                          "etal" => true
                          "autores" => array:3 [
                            0 => "J&#46;S&#46; Healey"
                            1 => "S&#46;J&#46; Connolly"
                            2 => "M&#46;R&#46; Gold"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1056/NEJMoa1105575"
                      "Revista" => array:6 [
                        "tituloSerie" => "N Engl J Med"
                        "fecha" => "2012"
                        "volumen" => "366"
                        "paginaInicial" => "120"
                        "paginaFinal" => "129"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22236222"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0090"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Suppression of paroxysmal atrial tachyarrhythmias &#8211; results of the SOPAT trial"
                      "autores" => array:1 [
                        0 => array:3 [
                          "colaboracion" => "SOPAT Investigators"
                          "etal" => true
                          "autores" => array:3 [
                            0 => "M&#46; Patten"
                            1 => "R&#46; Maas"
                            2 => "P&#46; Bauer"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.ehj.2004.06.014"
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur Heart J"
                        "fecha" => "2004"
                        "volumen" => "25"
                        "paginaInicial" => "1395"
                        "paginaFinal" => "1404"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15321697"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0095"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Prevention of atrial fibrillation after cardioversion&#58; results of the PAFAC trial"
                      "autores" => array:1 [
                        0 => array:3 [
                          "colaboracion" => "Prevention of Atrial Fibrillation after Cardioversion Investigators"
                          "etal" => true
                          "autores" => array:3 [
                            0 => "T&#46; Fetsch"
                            1 => "P&#46; Bauer"
                            2 => "R&#46; Engberding"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.ehj.2004.04.015"
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur Heart J"
                        "fecha" => "2004"
                        "volumen" => "25"
                        "paginaInicial" => "1385"
                        "paginaFinal" => "1394"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15302102"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0100"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Occult atrial fibrillation in cryptogenic stroke&#58; detection by 7-day electrocardiogram versus implantable cardiac monitors"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "Ritter"
                            1 => "A&#46; Martin"
                            2 => "T&#46; Duning"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1161/STROKEAHA.111.676189"
                      "Revista" => array:6 [
                        "tituloSerie" => "Stroke"
                        "fecha" => "2013"
                        "volumen" => "44"
                        "paginaInicial" => "1449"
                        "paginaFinal" => "1452"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23449264"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0105"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Guidelines for the prevention of stroke in patients with stroke and transient ischemic attack&#58; a guideline for healthcare professionals from the American Heart Association&#47;American Stroke Association"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "W&#46;N&#46; Kernan"
                            1 => "B&#46; Ovbiagele"
                            2 => "H&#46;R&#46; Black"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1161/STR.0000000000000024"
                      "Revista" => array:6 [
                        "tituloSerie" => "Stroke"
                        "fecha" => "2014"
                        "volumen" => "45"
                        "paginaInicial" => "2160"
                        "paginaFinal" => "2236"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24788967"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0110"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Frequent and prolonged asymptomatic episodes of paroxysmal atrial fibrillation revealed by automatic long-term event recorders in patients with a negative 24-hour Holter"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "F&#46; Roche"
                            1 => "J&#46;M&#46; Gaspoz"
                            2 => "A&#46; Da Costa"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Pacing Clin Electrophysiol"
                        "fecha" => "2002"
                        "volumen" => "25"
                        "paginaInicial" => "1587"
                        "paginaFinal" => "1593"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12494616"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0115"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Comparison of atrial fibrillation monitoring strategies after cryptogenic stroke &#40;from the Cryptogenic Stroke and Underlying AF Trial&#41;"
                      "autores" => array:1 [
                        0 => array:3 [
                          "colaboracion" => "CRYSTAL-AF Investigators"
                          "etal" => true
                          "autores" => array:3 [
                            0 => "W&#46;C&#46; Choe"
                            1 => "R&#46;S&#46; Passman"
                            2 => "J&#46; Brachmann"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.amjcard.2015.06.012"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Cardiol"
                        "fecha" => "2015"
                        "volumen" => "116"
                        "paginaInicial" => "889"
                        "paginaFinal" => "893"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26183793"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0120"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Preval&#234;ncia da fibrilha&#231;&#227;o auricular parox&#237;stica numa popula&#231;&#227;o avaliada por monitoriza&#231;&#227;o cont&#237;nua de 24 horas"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "J&#46; Primo"
                            1 => "H&#46; Gon&#231;alves"
                            2 => "A&#46; Macedo"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.repc.2016.11.005"
                      "Revista" => array:6 [
                        "tituloSerie" => "Rev Port Cardiol"
                        "fecha" => "2017"
                        "volumen" => "36"
                        "paginaInicial" => "535"
                        "paginaFinal" => "546"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28709762"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0125"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Prevalence of atrial fibrillation in the Portuguese population aged 40 and over&#58; the FAMA study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "D&#46; Bonhorst"
                            1 => "M&#46; Mendes"
                            2 => "P&#46; Adragao"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Rev Port Cardiol"
                        "fecha" => "2010"
                        "volumen" => "29"
                        "paginaInicial" => "331"
                        "paginaFinal" => "350"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20635561"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0130"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Epidemiology of atrial fibrillation&#58; European perspective"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "M&#46; Zoni-Berisso"
                            1 => "F&#46; Lercari"
                            2 => "T&#46; Carazza"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.2147/CLEP.S47385"
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Epidemiol"
                        "fecha" => "2014"
                        "volumen" => "6"
                        "paginaInicial" => "213"
                        "paginaFinal" => "220"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24966695"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib0135"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Epidemiology and significance of atrial fibrillation"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "K&#46;M&#46; Ryder"
                            1 => "E&#46;J&#46; Benjamin"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Cardiol"
                        "fecha" => "1999"
                        "volumen" => "84"
                        "paginaInicial" => "131R"
                        "paginaFinal" => "138R"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10568672"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib0140"
              "etiqueta" => "12"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Projections on the number of individuals with atrial fibrillation in the European Union&#44; from 2000 to 2060"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "B&#46;P&#46; Krijthe"
                            1 => "A&#46; Kunst"
                            2 => "E&#46;J&#46; Benjamin"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1093/eurheartj/eht280"
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur Heart J"
                        "fecha" => "2013"
                        "volumen" => "34"
                        "paginaInicial" => "2746"
                        "paginaFinal" => "2751"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23900699"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib0145"
              "etiqueta" => "13"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The prevalence of oral anticoagulation in patients with atrial fibrillation in Portugal&#58; systematic review and meta-analysis of observational studies"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "D&#46; Caldeira"
                            1 => "M&#46; Barra"
                            2 => "C&#46; David"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.repc.2014.02.014"
                      "Revista" => array:6 [
                        "tituloSerie" => "Rev Port Cardiol"
                        "fecha" => "2014"
                        "volumen" => "33"
                        "paginaInicial" => "555"
                        "paginaFinal" => "560"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25240861"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib0150"
              "etiqueta" => "14"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cryptogenic stroke and underlying atrial fibrillation"
                      "autores" => array:1 [
                        0 => array:3 [
                          "colaboracion" => "CRYSTAL AF Investigators"
                          "etal" => true
                          "autores" => array:3 [
                            0 => "T&#46; Sanna"
                            1 => "H&#46;C&#46; Diener"
                            2 => "R&#46;S&#46; Passman"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1056/NEJMoa1313600"
                      "Revista" => array:6 [
                        "tituloSerie" => "N Engl J Med"
                        "fecha" => "2014"
                        "volumen" => "370"
                        "paginaInicial" => "2478"
                        "paginaFinal" => "2486"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24963567"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib0155"
              "etiqueta" => "15"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Atrial fibrillation in patients with cryptogenic stroke"
                      "autores" => array:1 [
                        0 => array:3 [
                          "colaboracion" => "EMBRACE Investigators and Coordinators"
                          "etal" => true
                          "autores" => array:3 [
                            0 => "D&#46;J&#46; Gladstone"
                            1 => "M&#46; Spring"
                            2 => "P&#46; Dorian"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1056/NEJMoa1311376"
                      "Revista" => array:6 [
                        "tituloSerie" => "N Engl J Med"
                        "fecha" => "2014"
                        "volumen" => "370"
                        "paginaInicial" => "2467"
                        "paginaFinal" => "2477"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24963566"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib0160"
              "etiqueta" => "16"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Ablation versus amiodarone for treatment of persistent atrial fibrillation in patients with congestive heart failure and an implanted device&#58; results from the AATAC Multicenter Randomized Trial"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "L&#46; Di Biase"
                            1 => "P&#46; Mohanty"
                            2 => "S&#46; Mohanty"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1161/CIRCULATIONAHA.115.019406"
                      "Revista" => array:6 [
                        "tituloSerie" => "Circulation"
                        "fecha" => "2016"
                        "volumen" => "133"
                        "paginaInicial" => "1637"
                        "paginaFinal" => "1644"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27029350"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/21742049/0000003600000078/v1_201707290050/S2174204917302076/v1_201707290050/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "9917"
    "tipo" => "SECCION"
    "en" => array:2 [
      "titulo" => "Original Articles"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "en"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/21742049/0000003600000078/v1_201707290050/S2174204917302076/v1_201707290050/en/main.pdf?idApp=UINPBA00004E&text.app=https://revportcardiol.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2174204917302076?idApp=UINPBA00004E"
]
Share
Journal Information

Statistics

Follow this link to access the full text of the article

Editorial comment
Atrial fibrillation monitoring to reduce thromboembolic risk: Selecting the patient and the monitoring device
Monitorização eletrocardiográfica para a redução do risco tromboembólico: seleção do doente e do dispositivo de monitorização
Sérgio Barraa,
Corresponding author
sergioncbarra@gmail.com

Corresponding author.
, Rui Providênciab
a Cardiology Department, Papworth Hospital NHS Foundation Trust, Cambridge, UK
b Barts Heart Centre, Barts Health NHS Trust, London, UK
Read
5385
Times
was read the article
1823
Total PDF
3562
Total HTML
Share statistics
 array:26 [
  "pii" => "S2174204917302076"
  "issn" => "21742049"
  "doi" => "10.1016/j.repce.2016.12.020"
  "estado" => "S300"
  "fechaPublicacion" => "2017-07-01"
  "aid" => "1030"
  "copyright" => "Sociedade Portuguesa de Cardiologia"
  "copyrightAnyo" => "2017"
  "documento" => "simple-article"
  "crossmark" => 1
  "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
  "subdocumento" => "dis"
  "cita" => "Rev Port Cardiol. 2017;36:547-9"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:2 [
    "total" => 1807
    "formatos" => array:3 [
      "EPUB" => 163
      "HTML" => 1321
      "PDF" => 323
    ]
  ]
  "Traduccion" => array:1 [
    "en" => array:20 [
      "pii" => "S0870255116303821"
      "issn" => "08702551"
      "doi" => "10.1016/j.repc.2016.12.011"
      "estado" => "S300"
      "fechaPublicacion" => "2017-07-01"
      "aid" => "1030"
      "copyright" => "Sociedade Portuguesa de Cardiologia"
      "documento" => "simple-article"
      "crossmark" => 1
      "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
      "subdocumento" => "dis"
      "cita" => "Rev Port Cardiol. 2017;36:547-9"
      "abierto" => array:3 [
        "ES" => true
        "ES2" => true
        "LATM" => true
      ]
      "gratuito" => true
      "lecturas" => array:2 [
        "total" => 2405
        "formatos" => array:3 [
          "EPUB" => 188
          "HTML" => 1766
          "PDF" => 451
        ]
      ]
      "en" => array:10 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">Editorial comment</span>"
        "titulo" => "Atrial fibrillation monitoring to reduce thromboembolic risk&#58; Selecting the patient and the monitoring device"
        "tienePdf" => "en"
        "tieneTextoCompleto" => "en"
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "547"
            "paginaFinal" => "549"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "pt" => array:1 [
            "titulo" => "Monitoriza&#231;&#227;o eletrocardiogr&#225;fica para a redu&#231;&#227;o do risco tromboemb&#243;lico&#58; sele&#231;&#227;o do doente e do dispositivo de monitoriza&#231;&#227;o"
          ]
        ]
        "contieneTextoCompleto" => array:1 [
          "en" => true
        ]
        "contienePdf" => array:1 [
          "en" => true
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "S&#233;rgio Barra, Rui Provid&#234;ncia"
            "autores" => array:2 [
              0 => array:2 [
                "nombre" => "S&#233;rgio"
                "apellidos" => "Barra"
              ]
              1 => array:2 [
                "nombre" => "Rui"
                "apellidos" => "Provid&#234;ncia"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "en"
      "Traduccion" => array:1 [
        "en" => array:9 [
          "pii" => "S2174204917302076"
          "doi" => "10.1016/j.repce.2016.12.020"
          "estado" => "S300"
          "subdocumento" => ""
          "abierto" => array:3 [
            "ES" => true
            "ES2" => true
            "LATM" => true
          ]
          "gratuito" => true
          "lecturas" => array:1 [
            "total" => 0
          ]
          "idiomaDefecto" => "en"
          "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2174204917302076?idApp=UINPBA00004E"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0870255116303821?idApp=UINPBA00004E"
      "url" => "/08702551/0000003600000078/v1_201707241250/S0870255116303821/v1_201707241250/en/main.assets"
    ]
  ]
  "itemSiguiente" => array:20 [
    "pii" => "S2174204917302088"
    "issn" => "21742049"
    "doi" => "10.1016/j.repce.2017.05.008"
    "estado" => "S300"
    "fechaPublicacion" => "2017-07-01"
    "aid" => "1025"
    "copyright" => "Sociedade Portuguesa de Cardiologia"
    "documento" => "article"
    "crossmark" => 1
    "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
    "subdocumento" => "rev"
    "cita" => "Rev Port Cardiol. 2017;36:551-67"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 8347
      "formatos" => array:3 [
        "EPUB" => 240
        "HTML" => 7460
        "PDF" => 647
      ]
    ]
    "en" => array:13 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Review Article</span>"
      "titulo" => "Aspirin and blood pressure&#58; Effects when used alone or in combination with antihypertensive drugs"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "pt"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "551"
          "paginaFinal" => "567"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "pt" => array:1 [
          "titulo" => "Aspirina e press&#227;o arterial&#58; efeitos do uso isolado ou em associa&#231;&#227;o com f&#225;rmacos anti-hipertensores"
        ]
      ]
      "contieneResumen" => array:2 [
        "en" => true
        "pt" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig0015"
          "etiqueta" => "Figure 3"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr3.jpeg"
              "Alto" => 2415
              "Ancho" => 3000
              "Tamanyo" => 447467
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Major protective effects of low-dose aspirin&#46; AA&#58; arachidonic acid&#59; ATL&#58; aspirin-triggered lipoxin&#59; COX-1&#58; cyclooxygenase-1&#59; COX-2&#58; cyclooxygenase-2&#59; eNOS&#58; endothelial nitric oxide synthase&#59; NO&#58; nitric oxide&#59; PD&#58; protectin&#59; Rvs&#58; resolvins&#59; TXA<span class="elsevierStyleInf">2</span>&#58; thromboxane A<span class="elsevierStyleInf">2</span>&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Ana Catarina Costa, Marta Reina-Couto, Ant&#243;nio Albino-Teixeira, Teresa Sousa"
          "autores" => array:4 [
            0 => array:2 [
              "nombre" => "Ana Catarina"
              "apellidos" => "Costa"
            ]
            1 => array:2 [
              "nombre" => "Marta"
              "apellidos" => "Reina-Couto"
            ]
            2 => array:2 [
              "nombre" => "Ant&#243;nio"
              "apellidos" => "Albino-Teixeira"
            ]
            3 => array:2 [
              "nombre" => "Teresa"
              "apellidos" => "Sousa"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "en" => array:9 [
        "pii" => "S0870255117302895"
        "doi" => "10.1016/j.repc.2017.05.008"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => true
          "ES2" => true
          "LATM" => true
        ]
        "gratuito" => true
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "en"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0870255117302895?idApp=UINPBA00004E"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2174204917302088?idApp=UINPBA00004E"
    "url" => "/21742049/0000003600000078/v1_201707290050/S2174204917302088/v1_201707290050/en/main.assets"
  ]
  "itemAnterior" => array:20 [
    "pii" => "S217420491730199X"
    "issn" => "21742049"
    "doi" => "10.1016/j.repce.2016.11.013"
    "estado" => "S300"
    "fechaPublicacion" => "2017-07-01"
    "aid" => "964"
    "copyright" => "Sociedade Portuguesa de Cardiologia"
    "documento" => "article"
    "crossmark" => 1
    "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
    "subdocumento" => "fla"
    "cita" => "Rev Port Cardiol. 2017;36:535-46"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 3002
      "formatos" => array:3 [
        "EPUB" => 162
        "HTML" => 2357
        "PDF" => 483
      ]
    ]
    "en" => array:12 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Original Article</span>"
      "titulo" => "Prevalence of paroxysmal atrial fibrillation in a population assessed by continuous 24-hour monitoring"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "pt"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "535"
          "paginaFinal" => "546"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "pt" => array:1 [
          "titulo" => "Preval&#234;ncia da fibrilha&#231;&#227;o auricular parox&#237;stica numa popula&#231;&#227;o avaliada por monitoriza&#231;&#227;o cont&#237;nua de 24 horas"
        ]
      ]
      "contieneResumen" => array:2 [
        "en" => true
        "pt" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Jo&#227;o Primo, Helena Gon&#231;alves, Ana Macedo, Paula Russo, Telma Monteiro, Jo&#227;o Guimar&#227;es, Ovidio Costa"
          "autores" => array:7 [
            0 => array:2 [
              "nombre" => "Jo&#227;o"
              "apellidos" => "Primo"
            ]
            1 => array:2 [
              "nombre" => "Helena"
              "apellidos" => "Gon&#231;alves"
            ]
            2 => array:2 [
              "nombre" => "Ana"
              "apellidos" => "Macedo"
            ]
            3 => array:2 [
              "nombre" => "Paula"
              "apellidos" => "Russo"
            ]
            4 => array:2 [
              "nombre" => "Telma"
              "apellidos" => "Monteiro"
            ]
            5 => array:2 [
              "nombre" => "Jo&#227;o"
              "apellidos" => "Guimar&#227;es"
            ]
            6 => array:2 [
              "nombre" => "Ovidio"
              "apellidos" => "Costa"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "pt" => array:9 [
        "pii" => "S0870255117301270"
        "doi" => "10.1016/j.repc.2016.11.005"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => true
          "ES2" => true
          "LATM" => true
        ]
        "gratuito" => true
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "pt"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0870255117301270?idApp=UINPBA00004E"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S217420491730199X?idApp=UINPBA00004E"
    "url" => "/21742049/0000003600000078/v1_201707290050/S217420491730199X/v1_201707290050/en/main.assets"
  ]
  "asociados" => array:1 [
    0 => array:20 [
      "pii" => "S217420491730199X"
      "issn" => "21742049"
      "doi" => "10.1016/j.repce.2016.11.013"
      "estado" => "S300"
      "fechaPublicacion" => "2017-07-01"
      "aid" => "964"
      "copyright" => "Sociedade Portuguesa de Cardiologia"
      "documento" => "article"
      "crossmark" => 1
      "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
      "subdocumento" => "fla"
      "cita" => "Rev Port Cardiol. 2017;36:535-46"
      "abierto" => array:3 [
        "ES" => true
        "ES2" => true
        "LATM" => true
      ]
      "gratuito" => true
      "lecturas" => array:2 [
        "total" => 3002
        "formatos" => array:3 [
          "EPUB" => 162
          "HTML" => 2357
          "PDF" => 483
        ]
      ]
      "en" => array:12 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">Original Article</span>"
        "titulo" => "Prevalence of paroxysmal atrial fibrillation in a population assessed by continuous 24-hour monitoring"
        "tienePdf" => "en"
        "tieneTextoCompleto" => "en"
        "tieneResumen" => array:2 [
          0 => "en"
          1 => "pt"
        ]
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "535"
            "paginaFinal" => "546"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "pt" => array:1 [
            "titulo" => "Preval&#234;ncia da fibrilha&#231;&#227;o auricular parox&#237;stica numa popula&#231;&#227;o avaliada por monitoriza&#231;&#227;o cont&#237;nua de 24 horas"
          ]
        ]
        "contieneResumen" => array:2 [
          "en" => true
          "pt" => true
        ]
        "contieneTextoCompleto" => array:1 [
          "en" => true
        ]
        "contienePdf" => array:1 [
          "en" => true
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "Jo&#227;o Primo, Helena Gon&#231;alves, Ana Macedo, Paula Russo, Telma Monteiro, Jo&#227;o Guimar&#227;es, Ovidio Costa"
            "autores" => array:7 [
              0 => array:2 [
                "nombre" => "Jo&#227;o"
                "apellidos" => "Primo"
              ]
              1 => array:2 [
                "nombre" => "Helena"
                "apellidos" => "Gon&#231;alves"
              ]
              2 => array:2 [
                "nombre" => "Ana"
                "apellidos" => "Macedo"
              ]
              3 => array:2 [
                "nombre" => "Paula"
                "apellidos" => "Russo"
              ]
              4 => array:2 [
                "nombre" => "Telma"
                "apellidos" => "Monteiro"
              ]
              5 => array:2 [
                "nombre" => "Jo&#227;o"
                "apellidos" => "Guimar&#227;es"
              ]
              6 => array:2 [
                "nombre" => "Ovidio"
                "apellidos" => "Costa"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "en"
      "Traduccion" => array:1 [
        "pt" => array:9 [
          "pii" => "S0870255117301270"
          "doi" => "10.1016/j.repc.2016.11.005"
          "estado" => "S300"
          "subdocumento" => ""
          "abierto" => array:3 [
            "ES" => true
            "ES2" => true
            "LATM" => true
          ]
          "gratuito" => true
          "lecturas" => array:1 [
            "total" => 0
          ]
          "idiomaDefecto" => "pt"
          "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0870255117301270?idApp=UINPBA00004E"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S217420491730199X?idApp=UINPBA00004E"
      "url" => "/21742049/0000003600000078/v1_201707290050/S217420491730199X/v1_201707290050/en/main.assets"
    ]
  ]
  "en" => array:12 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Editorial comment</span>"
    "titulo" => "Atrial fibrillation monitoring to reduce thromboembolic risk&#58; Selecting the patient and the monitoring device"
    "tieneTextoCompleto" => true
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "547"
        "paginaFinal" => "549"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "S&#233;rgio Barra, Rui Provid&#234;ncia"
        "autores" => array:2 [
          0 => array:4 [
            "nombre" => "S&#233;rgio"
            "apellidos" => "Barra"
            "email" => array:1 [
              0 => "sergioncbarra&#64;gmail&#46;com"
            ]
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">&#42;</span>"
                "identificador" => "cor0005"
              ]
            ]
          ]
          1 => array:3 [
            "nombre" => "Rui"
            "apellidos" => "Provid&#234;ncia"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:2 [
          0 => array:3 [
            "entidad" => "Cardiology Department&#44; Papworth Hospital NHS Foundation Trust&#44; Cambridge&#44; UK"
            "etiqueta" => "a"
            "identificador" => "aff0005"
          ]
          1 => array:3 [
            "entidad" => "Barts Heart Centre&#44; Barts Health NHS Trust&#44; London&#44; UK"
            "etiqueta" => "b"
            "identificador" => "aff0010"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Corresponding author&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "pt" => array:1 [
        "titulo" => "Monitoriza&#231;&#227;o eletrocardiogr&#225;fica para a redu&#231;&#227;o do risco tromboemb&#243;lico&#58; sele&#231;&#227;o do doente e do dispositivo de monitoriza&#231;&#227;o"
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Atrial fibrillation &#40;AF&#41; is the most common sustained cardiac arrhythmia and is associated with a five-fold increased risk of stroke&#46; At least 15-20&#37; of strokes are attributed to underlying AF&#44; but subclinical AF may be the cause of an additional number of cerebrovascular events&#46; Data from cardiac implantable electronic devices &#40;CIEDs&#41; have shown that subclinical atrial tachyarrhythmias lasting more than six minutes are associated with increased risk of thromboembolism&#46;<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">1</span></a> The often silent and intermittent nature of AF poses a problem&#59; more than half of AF episodes are asymptomatic<a class="elsevierStyleCrossRefs" href="#bib0090"><span class="elsevierStyleSup">2&#44;3</span></a> and therefore identifying patients at risk remains a challenge&#46; This is a good illustration of the importance of AF monitoring&#46; Continuous monitoring with implantable cardiac monitors is now widely used in patients with cryptogenic stroke to identify those with silent AF who warrant antithrombotic therapy&#46;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">4</span></a> In this context&#44; the prevalence of AF is approximately 20&#37;&#46; Stroke guidelines state that prolonged rhythm monitoring for AF of approximately 30 days is reasonable within six months of a cerebrovascular event with no apparent cause&#46;<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">5</span></a> In addition to risk stratification for stroke prevention&#44; AF monitoring and detection is also useful to assess the efficacy of rhythm control strategies&#44; prevent inappropriate shocks in implantable cardioverter-defibrillator &#40;ICD&#41; patients and maximize the benefit of cardiac resynchronization therapy &#40;CRT&#41;&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">Detection of subclinical atrial tachyarrhythmias can be performed through a variety of tools&#44; including external surface monitoring with intermittent 12-lead electrocardiogram&#44; ambulatory Holter monitors&#44; cardiac event recorders&#44; portable electrocardiogram recorders &#40;such as AliveCor&#41; and the more recent adhesive patch electrocardiographic monitors&#44; as well as CIEDs such as implantable loop recorders&#44; dual-chamber pacemakers or ICDs and CRT devices&#46; Although longer-term Holter and event recorders have superior diagnostic yield compared to intermittent 12-lead ECGs&#44;<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">6</span></a> the need for a transmitter device and lower patient compliance represent limitations&#46; Patient compliance diminishes as the nominal monitoring duration increases&#44; owing to concerns regarding skin irritation and the inconvenience of performing daily activities while wearing a monitor&#46; More recent methods include simpler patch-type monitors which provide instant feedback and may lead to immediate changes in medical management&#46; In patients with CIEDs&#44; the possibility of continuous long-term monitoring increases the monitoring sensitivity&#46; In the setting of post-cryptogenic stroke&#44; long-term continuous monitoring with an implantable cardiac monitor has been shown to be superior in detecting AF to any intermittent monitoring strategy&#46;<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">7</span></a> However&#44; their applicability is hampered by the need for an invasive procedure&#46; Ideally&#44; the optimal monitoring device should be non-invasive&#44; inexpensive&#44; simple to use and able to provide continuous long-term monitoring with immediate feedback&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">In this issue of the <span class="elsevierStyleItalic">Journal</span>&#44; Primo et al&#46; have elegantly provided an assessment of the prevalence of AF&#44; based on episodes of atrial arrhythmia lasting for more than 30 seconds&#44; obtained through a 12-lead Holter monitor&#46;<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">8</span></a> Their study cohort included patients referred for Holter monitoring for a variety of reasons&#44; as determined by their general practitioners&#46; The main strengths of this study are &#40;1&#41; its prospective nature&#44; &#40;2&#41; the use of 12-lead electrocardiographic monitoring&#44; which enables more accurate determination of the underlying rhythm &#40;with potential therapeutic implications&#41; compared to the standard three-lead Holter&#44; &#40;3&#41; continuous 24-hour monitoring&#44; as opposed to a single 12-lead ECG as used in the FAMA study&#44;<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">9</span></a> with improved diagnostic yield&#44; &#40;4&#41; the inclusion of a relatively unbiased population of patients seen due to a variety of cardiovascular symptoms&#44; enabling a more accurate representation of AF prevalence in this context&#44; &#40;5&#41; an independent and blinded analysis by up to three different electrophysiologists&#44; and &#40;6&#41; the large size of the study sample&#44; allowing narrow 95&#37; confidence intervals&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">Several important observations can be made on the results of this study&#46; Firstly&#44; more than 10 out of 100 patients participating in this study had documented AF or atrial flutter &#40;of which one fifth with paroxysmal AF&#41;&#46; This figure is higher than previously reported in both European and American studies&#44;<a class="elsevierStyleCrossRefs" href="#bib0130"><span class="elsevierStyleSup">10&#44;11</span></a> although AF prevalence in individuals aged 80 years or older may indeed be well above 10&#37;&#46;<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">10</span></a> In 2010&#44; the number of adults aged &#8805;55 years with AF corresponded to 1&#46;8&#37; of the total European Union population&#44; and this figure will rise to 3&#46;5&#37; by 2060&#46; This increase will be particularly dramatic in adults aged over 75&#46;<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">12</span></a> The higher prevalence of AF in the present study is likely a result of the criteria used for patient selection&#46; A higher AF prevalence should be expected in patients who present with cardiovascular symptoms&#44; even if non-specific&#44; compared to a cohort of asymptomatic patients&#46; However&#44; this study does provide us with a reasonably accurate estimate of AF prevalence among symptomatic patients who are typically seen by their general practitioners&#46; The number may be higher in the context of a more specialized cardiology outpatient clinic&#46; It is also noteworthy that advances in treatment for chronic cardiac and non-cardiac conditions&#44; aging populations&#44; and improved ability to diagnose AF through a wider range of monitoring devices may explain the higher prevalence of AF in more recent studies compared with older ones&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">Secondly&#44; the vast majority of patients with documented paroxysmal AF had never had any ECG documentation of this arrhythmia and hence only a minority of these were anticoagulated&#46; As the authors state&#44; the very low use of anticoagulation is mainly a reflection of an undiagnosed cohort&#44; although faulty judgments on the risk of bleeding&#44; especially in elderly patients&#44; also help explain the low rate of anticoagulation prescription in AF patients&#44; as shown in the Portuguese setting&#46;<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">13</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">In patients with cardiovascular symptoms&#44; manual pulse palpation should be performed to determine the presence of an irregular pulse that could indicate underlying AF&#46; A 12-lead electrocardiogram should then be performed on all patients in whom a diagnosis of AF is suspected based on the detection of an irregular pulse&#46; The present study demonstrates that 24-hour Holter should also be considered for all of these patients&#44; with consideration of longer monitoring in patients whose characteristics may put them at higher risk of AF&#58; male gender&#44; advanced age&#44; or a history of hypertension&#44; chronic obstructive pulmonary disease&#44; cerebrovascular or ischemic heart disease&#46; Likewise&#44; a large waist circumference&#44; sedentary lifestyle and high alcohol intake are also predictors of AF&#46; Young age should not preclude appropriate investigation&#44; as AF is seen throughout all age strata&#44; as this study shows&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Notwithstanding the unequivocal merit of this study&#44; we should point out that&#44; in patients considered to be at high risk of AF&#44; and especially those who have sustained a cerebrovascular event&#44; 24-hour Holter monitoring may be insufficient&#46; It is well established that the longer a patient is monitored &#40;and this is not exclusive to implantable cardiac monitors&#41;&#44; the greater the likelihood of detecting sustained atrial arrhythmias including asymptomatic AF&#44; with subsequent impact on the rate of anticoagulation prescription&#46;<a class="elsevierStyleCrossRefs" href="#bib0150"><span class="elsevierStyleSup">14&#44;15</span></a></p><p id="par0040" class="elsevierStylePara elsevierViewall">The role of AF monitoring for the selection of patients who could benefit from catheter ablation is much less straightforward&#46; AF ablation is mostly indicated in symptomatic patients for quality-of-life purposes&#46; AF ablation in asymptomatic patients is not generally recommended&#44; and this is unlikely to change in the near future unless studies such as the Catheter Ablation Versus Antiarrhythmic Drug Therapy for Atrial Fibrillation &#40;CABANA&#41; trial demonstrate that successful AF ablation can lead to decreased long-term risk of mortality or stroke compared with medical management&#46; Despite promising results by Di Biase et al&#46; in a recent study of heart failure patients with AF&#44;<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">16</span></a> all other evidence supporting the utility of AF ablation in stroke or mortality risk reduction is based on observational data&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">To summarize&#44; 24-hour 12-lead Holter monitors are an elegant screening method for patients with a multitude of cardiovascular symptoms&#44; enabling detection of paroxysmal AF or atrial flutter in a non-negligible percentage of patients&#46; In patients with risk factors for AF and especially a recent history of thromboembolism&#44; more prolonged or long-term continuous AF monitoring should be performed wherever possible&#46; Even short-lasting atrial arrhythmias carry a significantly increased risk of thromboembolism and therefore any documented AF of at least a few minutes should lead to consideration of oral anticoagulation prophylaxis as per the CHA<span class="elsevierStyleInf">2</span>DS<span class="elsevierStyleInf">2</span>-VASc score&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflicts of interest</span><p id="par0050" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interest to declare&#46;</p></span></span>"
    "textoCompletoSecciones" => array:1 [
      "secciones" => array:2 [
        0 => array:2 [
          "identificador" => "sec0005"
          "titulo" => "Conflicts of interest"
        ]
        1 => array:1 [
          "titulo" => "References"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0005"
          "bibliografiaReferencia" => array:16 [
            0 => array:3 [
              "identificador" => "bib0085"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Subclinical atrial fibrillation and the risk of stroke"
                      "autores" => array:1 [
                        0 => array:3 [
                          "colaboracion" => "ASSERT Investigators"
                          "etal" => true
                          "autores" => array:3 [
                            0 => "J&#46;S&#46; Healey"
                            1 => "S&#46;J&#46; Connolly"
                            2 => "M&#46;R&#46; Gold"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1056/NEJMoa1105575"
                      "Revista" => array:6 [
                        "tituloSerie" => "N Engl J Med"
                        "fecha" => "2012"
                        "volumen" => "366"
                        "paginaInicial" => "120"
                        "paginaFinal" => "129"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22236222"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0090"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Suppression of paroxysmal atrial tachyarrhythmias &#8211; results of the SOPAT trial"
                      "autores" => array:1 [
                        0 => array:3 [
                          "colaboracion" => "SOPAT Investigators"
                          "etal" => true
                          "autores" => array:3 [
                            0 => "M&#46; Patten"
                            1 => "R&#46; Maas"
                            2 => "P&#46; Bauer"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.ehj.2004.06.014"
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur Heart J"
                        "fecha" => "2004"
                        "volumen" => "25"
                        "paginaInicial" => "1395"
                        "paginaFinal" => "1404"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15321697"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0095"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Prevention of atrial fibrillation after cardioversion&#58; results of the PAFAC trial"
                      "autores" => array:1 [
                        0 => array:3 [
                          "colaboracion" => "Prevention of Atrial Fibrillation after Cardioversion Investigators"
                          "etal" => true
                          "autores" => array:3 [
                            0 => "T&#46; Fetsch"
                            1 => "P&#46; Bauer"
                            2 => "R&#46; Engberding"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.ehj.2004.04.015"
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur Heart J"
                        "fecha" => "2004"
                        "volumen" => "25"
                        "paginaInicial" => "1385"
                        "paginaFinal" => "1394"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15302102"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0100"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Occult atrial fibrillation in cryptogenic stroke&#58; detection by 7-day electrocardiogram versus implantable cardiac monitors"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "Ritter"
                            1 => "A&#46; Martin"
                            2 => "T&#46; Duning"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1161/STROKEAHA.111.676189"
                      "Revista" => array:6 [
                        "tituloSerie" => "Stroke"
                        "fecha" => "2013"
                        "volumen" => "44"
                        "paginaInicial" => "1449"
                        "paginaFinal" => "1452"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23449264"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0105"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Guidelines for the prevention of stroke in patients with stroke and transient ischemic attack&#58; a guideline for healthcare professionals from the American Heart Association&#47;American Stroke Association"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "W&#46;N&#46; Kernan"
                            1 => "B&#46; Ovbiagele"
                            2 => "H&#46;R&#46; Black"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1161/STR.0000000000000024"
                      "Revista" => array:6 [
                        "tituloSerie" => "Stroke"
                        "fecha" => "2014"
                        "volumen" => "45"
                        "paginaInicial" => "2160"
                        "paginaFinal" => "2236"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24788967"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0110"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Frequent and prolonged asymptomatic episodes of paroxysmal atrial fibrillation revealed by automatic long-term event recorders in patients with a negative 24-hour Holter"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "F&#46; Roche"
                            1 => "J&#46;M&#46; Gaspoz"
                            2 => "A&#46; Da Costa"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Pacing Clin Electrophysiol"
                        "fecha" => "2002"
                        "volumen" => "25"
                        "paginaInicial" => "1587"
                        "paginaFinal" => "1593"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12494616"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0115"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Comparison of atrial fibrillation monitoring strategies after cryptogenic stroke &#40;from the Cryptogenic Stroke and Underlying AF Trial&#41;"
                      "autores" => array:1 [
                        0 => array:3 [
                          "colaboracion" => "CRYSTAL-AF Investigators"
                          "etal" => true
                          "autores" => array:3 [
                            0 => "W&#46;C&#46; Choe"
                            1 => "R&#46;S&#46; Passman"
                            2 => "J&#46; Brachmann"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.amjcard.2015.06.012"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Cardiol"
                        "fecha" => "2015"
                        "volumen" => "116"
                        "paginaInicial" => "889"
                        "paginaFinal" => "893"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26183793"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0120"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Preval&#234;ncia da fibrilha&#231;&#227;o auricular parox&#237;stica numa popula&#231;&#227;o avaliada por monitoriza&#231;&#227;o cont&#237;nua de 24 horas"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "J&#46; Primo"
                            1 => "H&#46; Gon&#231;alves"
                            2 => "A&#46; Macedo"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.repc.2016.11.005"
                      "Revista" => array:6 [
                        "tituloSerie" => "Rev Port Cardiol"
                        "fecha" => "2017"
                        "volumen" => "36"
                        "paginaInicial" => "535"
                        "paginaFinal" => "546"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28709762"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0125"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Prevalence of atrial fibrillation in the Portuguese population aged 40 and over&#58; the FAMA study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "D&#46; Bonhorst"
                            1 => "M&#46; Mendes"
                            2 => "P&#46; Adragao"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Rev Port Cardiol"
                        "fecha" => "2010"
                        "volumen" => "29"
                        "paginaInicial" => "331"
                        "paginaFinal" => "350"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20635561"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0130"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Epidemiology of atrial fibrillation&#58; European perspective"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "M&#46; Zoni-Berisso"
                            1 => "F&#46; Lercari"
                            2 => "T&#46; Carazza"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.2147/CLEP.S47385"
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Epidemiol"
                        "fecha" => "2014"
                        "volumen" => "6"
                        "paginaInicial" => "213"
                        "paginaFinal" => "220"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24966695"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib0135"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Epidemiology and significance of atrial fibrillation"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "K&#46;M&#46; Ryder"
                            1 => "E&#46;J&#46; Benjamin"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Cardiol"
                        "fecha" => "1999"
                        "volumen" => "84"
                        "paginaInicial" => "131R"
                        "paginaFinal" => "138R"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10568672"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib0140"
              "etiqueta" => "12"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Projections on the number of individuals with atrial fibrillation in the European Union&#44; from 2000 to 2060"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "B&#46;P&#46; Krijthe"
                            1 => "A&#46; Kunst"
                            2 => "E&#46;J&#46; Benjamin"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1093/eurheartj/eht280"
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur Heart J"
                        "fecha" => "2013"
                        "volumen" => "34"
                        "paginaInicial" => "2746"
                        "paginaFinal" => "2751"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23900699"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib0145"
              "etiqueta" => "13"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The prevalence of oral anticoagulation in patients with atrial fibrillation in Portugal&#58; systematic review and meta-analysis of observational studies"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "D&#46; Caldeira"
                            1 => "M&#46; Barra"
                            2 => "C&#46; David"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.repc.2014.02.014"
                      "Revista" => array:6 [
                        "tituloSerie" => "Rev Port Cardiol"
                        "fecha" => "2014"
                        "volumen" => "33"
                        "paginaInicial" => "555"
                        "paginaFinal" => "560"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25240861"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib0150"
              "etiqueta" => "14"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cryptogenic stroke and underlying atrial fibrillation"
                      "autores" => array:1 [
                        0 => array:3 [
                          "colaboracion" => "CRYSTAL AF Investigators"
                          "etal" => true
                          "autores" => array:3 [
                            0 => "T&#46; Sanna"
                            1 => "H&#46;C&#46; Diener"
                            2 => "R&#46;S&#46; Passman"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1056/NEJMoa1313600"
                      "Revista" => array:6 [
                        "tituloSerie" => "N Engl J Med"
                        "fecha" => "2014"
                        "volumen" => "370"
                        "paginaInicial" => "2478"
                        "paginaFinal" => "2486"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24963567"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib0155"
              "etiqueta" => "15"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Atrial fibrillation in patients with cryptogenic stroke"
                      "autores" => array:1 [
                        0 => array:3 [
                          "colaboracion" => "EMBRACE Investigators and Coordinators"
                          "etal" => true
                          "autores" => array:3 [
                            0 => "D&#46;J&#46; Gladstone"
                            1 => "M&#46; Spring"
                            2 => "P&#46; Dorian"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1056/NEJMoa1311376"
                      "Revista" => array:6 [
                        "tituloSerie" => "N Engl J Med"
                        "fecha" => "2014"
                        "volumen" => "370"
                        "paginaInicial" => "2467"
                        "paginaFinal" => "2477"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24963566"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib0160"
              "etiqueta" => "16"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Ablation versus amiodarone for treatment of persistent atrial fibrillation in patients with congestive heart failure and an implanted device&#58; results from the AATAC Multicenter Randomized Trial"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "L&#46; Di Biase"
                            1 => "P&#46; Mohanty"
                            2 => "S&#46; Mohanty"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1161/CIRCULATIONAHA.115.019406"
                      "Revista" => array:6 [
                        "tituloSerie" => "Circulation"
                        "fecha" => "2016"
                        "volumen" => "133"
                        "paginaInicial" => "1637"
                        "paginaFinal" => "1644"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27029350"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/21742049/0000003600000078/v1_201707290050/S2174204917302076/v1_201707290050/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "9917"
    "tipo" => "SECCION"
    "en" => array:2 [
      "titulo" => "Original Articles"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "en"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/21742049/0000003600000078/v1_201707290050/S2174204917302076/v1_201707290050/en/main.pdf?idApp=UINPBA00004E&text.app=https://revportcardiol.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2174204917302076?idApp=UINPBA00004E"
]
Article information
ISSN: 21742049
Original language: English
The statistics are updated each day
Year/Month Html Pdf Total
2024 November 11 3 14
2024 October 132 31 163
2024 September 54 25 79
2024 August 94 41 135
2024 July 42 36 78
2024 June 40 23 63
2024 May 39 23 62
2024 April 39 24 63
2024 March 40 27 67
2024 February 41 17 58
2024 January 34 22 56
2023 December 20 35 55
2023 November 59 37 96
2023 October 43 12 55
2023 September 41 22 63
2023 August 43 14 57
2023 July 24 8 32
2023 June 25 11 36
2023 May 44 29 73
2023 April 24 12 36
2023 March 56 23 79
2023 February 57 16 73
2023 January 22 15 37
2022 December 43 33 76
2022 November 44 36 80
2022 October 42 28 70
2022 September 29 35 64
2022 August 28 30 58
2022 July 25 40 65
2022 June 36 33 69
2022 May 32 50 82
2022 April 30 38 68
2022 March 25 48 73
2022 February 25 48 73
2022 January 31 33 64
2021 December 21 31 52
2021 November 34 37 71
2021 October 44 49 93
2021 September 21 25 46
2021 August 33 43 76
2021 July 19 30 49
2021 June 30 34 64
2021 May 40 36 76
2021 April 73 76 149
2021 March 49 26 75
2021 February 43 12 55
2021 January 32 13 45
2020 December 36 9 45
2020 November 46 11 57
2020 October 24 14 38
2020 September 47 14 61
2020 August 23 11 34
2020 July 40 17 57
2020 June 31 11 42
2020 May 45 12 57
2020 April 32 11 43
2020 March 48 13 61
2020 February 56 15 71
2020 January 45 5 50
2019 December 40 9 49
2019 November 24 7 31
2019 October 37 2 39
2019 September 30 9 39
2019 August 36 12 48
2019 July 32 7 39
2019 June 33 18 51
2019 May 21 16 37
2019 April 16 20 36
2019 March 57 12 69
2019 February 41 8 49
2019 January 19 6 25
2018 December 61 10 71
2018 November 81 16 97
2018 October 210 13 223
2018 September 63 11 74
2018 August 30 4 34
2018 July 10 6 16
2018 June 24 6 30
2018 May 16 8 24
2018 April 23 3 26
2018 March 35 10 45
2018 February 11 4 15
2018 January 26 11 37
2017 December 34 8 42
2017 November 33 16 49
2017 October 36 11 47
2017 September 39 22 61
2017 August 117 24 141
2017 July 1 1 2
Show all

Follow this link to access the full text of the article

Idiomas
Revista Portuguesa de Cardiologia (English edition)
en pt

Are you a health professional able to prescribe or dispense drugs?

Você é um profissional de saúde habilitado a prescrever ou dispensar medicamentos

By checking that you are a health professional, you are stating that you are aware and accept that the Portuguese Journal of Cardiology (RPC) is the Data Controller that processes the personal information of users of its website, with its registered office at Campo Grande, n.º 28, 13.º, 1700-093 Lisbon, telephone 217 970 685 and 217 817 630, fax 217 931 095, and email revista@spc.pt. I declare for all purposes that the information provided herein is accurate and correct.