NDLI: Prevalence and predictors of paroxysmal atrial fibrillation on Holter monitor in patients with stroke or transient ischemic attack.

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Prevalence and predictors of paroxysmal atrial fibrillation on Holter monitor in patients with stroke or transient ischemic attack.

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Prevalence and predictors of paroxysmal atrial fibrillation on Holter monitor in patients with stroke or transient ischemic attack.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Jeerakathil, Thomas J. Najjar, Emad Choy, Jonathan Majumdar, Sumit R. Alhadramy, Osama Saqqur, Maher
Description	Country affiliation: Canada Author Affiliation: Alhadramy O ( Division of Cardiology, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada. msaqqur@ualberta.ca)
Abstract	BACKGROUND AND PURPOSE: Our aims were to quantify the yield of Holter monitor for detection of paroxysmal atrial fibrillation (PAF) in patients with stroke and TIA, and to determine potential predictors of PAF to allow more focused testing. METHODS: We reviewed records of 1128 consecutive patients attending a university stroke clinic from September 2005 to September 2006 and identified 426 patients with definite TIA or stroke. We abstracted clinical, cardiac imaging, and neuroimaging data. Logistic regression analysis was performed to determine independent predictors of PAF on Holter monitor. RESULTS: Overall, 413 of 426 patients (65 ± 15 years; male, 49.8%) with a definite TIA (53%) or stroke (47%) underwent Holter monitoring for a mean of 22.6 hours. PAF occurred in 39 patients (9.2%) all older than age 55 years. PAF lasting > 30 seconds was evident in 11 patients (2.5%). The other 28 patients had PAF < 30 seconds (6.5%). In multivariate analyses, number of acute (odds ratio [OR], 1.7 for each 1 lesion increase; 95% confidence interval [CI], 1.2-2.6; P = 0.0047) and chronic (OR, 1.6 for each 1 lesion increase; 95% CI, 1.2-2.3; P = 0.0001) infarcts on brain CT, number of chronic infarcts on MRI (OR, 3.0 for each 1 lesion increase; 95% CI, 1.7-5.1; P < 0.0001), and any acute cortical infarct on imaging (OR, 5.8; 95% CI, 1.9-17.8; P = 0.0023) were associated with PAF. CONCLUSIONS: PAF is present in 9.2% of patients with definite stroke or TIA. Age older than 55 years and presence of acute or chronic brain infarcts on neuroimaging are strongly associated with PAF.
ISSN	00392499
e-ISSN	15244628
Journal	Stroke
Issue Number	11
Volume Number	41
Language	English
Publisher	Lippincott Williams & Wilkins (on behalf of the American Heart Association)
Publisher Date	2010-11-01
Publisher Place	United States
Access Restriction	Open
Subject Keyword	Atrial Fibrillation Epidemiology Physiopathology Electrocardiography, Ambulatory Ischemic Attack, Transient Complications Stroke Pathology Logistic Models Magnetic Resonance Imaging Predictive Value Of Tests Retrospective Studies Risk Factors Tomography, X-ray Computed Discipline Cardiology
Content Type	Text
Resource Type	Article
Subject	Cardiology and Cardiovascular Medicine Neuroscience Advanced and Specialized Nursing Neurology (clinical)

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