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Continuous stroke unit electrocardiographic monitoring versus 24-hour Holter electrocardiography for detection of paroxysmal atrial fibrillation after stroke.
| Content Provider | Semantic Scholar |
|---|---|
| Author | Rizos, Timolaos Güntner, Janina Jenetzky, Ekkehart Marquardt, Lars Reichardt, Christine Becker, Ruediger Reinhardt, Roland Hepp, Thomas Kirchhof, Paulus Aleynichenko, Elena Ringleb, Peter Hacke, Werner Veltkamp, Roland |
| Copyright Year | 2012 |
| Abstract | BACKGROUND AND PURPOSE Cardioembolism in paroxysmal atrial fibrillation (pxAF) is a frequent cause of ischemic stroke. Sensitive detection of pxAF after stroke is crucial for adequate secondary stroke prevention; the optimal diagnostic modality to detect pxAF on stroke units is unknown. We compared 24-hour Holter electrocardiography (ECG) with continuous stroke unit ECG monitoring (CEM) for pxAF detection. METHODS Patients with acute ischemic stroke or transient ischemic attack were prospectively enrolled. After a 12-channel ECG on admission, all patients received 24-hour Holter ECG and CEM. Additionally, ECG monitoring data underwent automated analysis using dedicated software to identify pxAF. Patients with a history of atrial fibrillation or with atrial fibrillation on the admission ECG were excluded. RESULTS Four hundred ninety-six patients (median age, 69 years; 61.5% male) fulfilled all inclusion criteria (ischemic stroke: 80.4%; transient ischemic attack: 19.6%). Median stroke unit stay lasted 88.8 hours (interquartile range, 65.0-122.0). ECG data for automated CEM analysis were available for a median time of 64.0 hours (43.0-89.8). Paroxysmal AF was documented in 41 of 496 patients (8.3%). Of these, Holter detected pxAF in 34.1%; CEM in 65.9%; and automated CEM in 92.7%. CEM and automated CEM detected significantly more patients with pxAF than Holter (P<0.001), and automated CEM detected more patients than CEM (P<0.001). CONCLUSIONS Automated analysis of CEM improves pxAF detection in patients with stroke on stroke units compared with 24-hour Holter ECG. The comparative usefulness of prolonged or repetitive Holter ECG recordings requires further evaluation. |
| File Format | PDF HTM / HTML |
| Alternate Webpage(s) | http://stroke.ahajournals.org/content/strokeaha/43/10/2689.full.pdf?download=true |
| Alternate Webpage(s) | http://stroke.ahajournals.org/content/strokeaha/early/2012/08/07/STROKEAHA.112.654954.full.pdf?download=true |
| Alternate Webpage(s) | http://stroke.ahajournals.org/content/strokeaha/43/10/2689.full.pdf |
| Alternate Webpage(s) | http://stroke.ahajournals.org/content/strokeaha/early/2012/08/07/STROKEAHA.112.654954.full.pdf |
| PubMed reference number | 22871678v1 |
| Volume Number | 43 |
| Issue Number | 10 |
| Journal | Stroke |
| Language | English |
| Access Restriction | Open |
| Subject Keyword | Cerebral Infarction Cerebrovascular accident Document completion status - Documented Electrocardiography, Ambulatory Exclusion Heart Atrium Holter Electrocardiography Hypoxic-Ischemic Encephalopathy Leukemia, Myelocytic, Acute Ninety Paroxysmal atrial fibrillation Paroxysmal nocturnal hemoglobinuria Patients Sixty Nine Transient Ischemic Attack Ventricular Fibrillation Volkmann Contracture |
| Content Type | Text |
| Resource Type | Article |
