Improved screening for silent atrial fibrillation after ischaemic stroke
Open accessAbstract
OBJECTIVES: To what extent silent paroxysmal atrial fibrillation (AF) is present in ischaemic stroke patients has not been established. We hypothesized that brief intermittent long-term electrocardiogram (ECG) recordings at regular time intervals are more effective than short-term continuous ECG monitoring in detecting silent AF episodes. METHODS AND RESULTS: Consecutive patients who had suffered an ischaemic stroke/transient ischaemic attack (TIA) and were without known AF underwent a 24 h continuous ECG recording and performed 10 s rhythm registrations using a hand-held ECG recorder twice daily for 30 days and when arrhythmia symptoms occured. Two hundred and forty-nine stroke patients were included. Mean National Institute of Health Stroke Scale (NIHSS) score was 0.9 (0-10). In total, 17 patients were diagnosed with AF. One hundred and eight AF episodes were diagnosed in 15 patients using intermittent recording, out of which 22% where unscheduled symptom triggered episodes. In three patients AF was diagnosed with both methods and in two patients AF was detected exclusively with 24 h Holter monitoring. A significant difference in favour of the hand-held ECG was shown between the two methods (P = 0.013). The total prevalence of AF was 6.8% and increased to 11.8% in patients ≥75 years. No AF was found in patients <65 years. CONCLUSIONS: Prolonged brief intermittent arrhythmia screening substantially improves the detection of silent paroxysmal AF in patients with a recent ischaemic stroke/TIA, and thus facilitates the detection of patients who should receive oral anticoagulant treatment.
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- Authors
- Doliwa Sobocinski, P., Anggardh Rooth, E., Frykman Kull, V., von Arbin, M., Wallen, H., & Rosenqvist, M.
- Affiliations
- Karolinska Institutet (SE)
- Venue
- Europace
- Publisher
- Oxford University Press (OUP)
- Published
- 2012-02-02
- Volume
- 14
- Issue
- 8
- Pages
- 1112-1116
- ISSN
- 1099-5129 (ISSN-L)
- 1532-2092
- OpenAlex
- W2166226519
- Semantic Scholar
- 7663b1d641034102b70538930be73cfc48290efb
- Cited by
- 112
- References
- 22
- Citations by year
- 2024: 3 · 2023: 4 · 2022: 5 · 2021: 10 · 2020: 11 · 2019: 6 · 2018: 6 · 2017: 11 · 2016: 12 · 2015: 16 · 2014: 15 · 2013: 9 · 2012: 4
- FWCI
- 9.06
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- EP Europace (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Atrial Fibrillation Management and Outcomes
- Health Sciences › Medicine › Epidemiology › Acute Ischemic Stroke Management
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Cardiovascular and Diving-Related Complications
- Keywords
- silent atrial fibrillation, paroxysmal atrial fibrillation, ischemic stroke, transient ischemic attack, 24-hour Holter monitoring, arrhythmia screening, oral anticoagulation, stroke recurrence risk, age-related prevalence
- MeSH terms
- Adult, Aged, Aged, 80 and over, Atrial Fibrillation, Ischemic Attack, Transient, Electrocardiography, Female, Humans, Male, Mass Screening, Middle Aged, Electrocardiography, Ambulatory, Prevalence, Stroke
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