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Detection of paroxysmal atrial fibrillation in 994 patients with a cerebrovascular event by intermittent 21-day ECG-monitoring and 7-day continuous Holter-recording
Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Avdelningen för medicin.ORCID-id: 0000-0003-1598-4690
Danderyd University Hospital, Karolinska Institutet, Stockholm, Sweden.
Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Avdelningen för medicin.ORCID-id: 0000-0001-9271-9976
2022 (Engelska)Ingår i: Upsala Journal of Medical Sciences, ISSN 0300-9734, E-ISSN 2000-1967, Vol. 127, artikel-id e8318Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Background: The detection of paroxysmal atrial fibrillation (AF) is of importance in stroke care. The method used is continuous electrocardiogram (ECG)-monitoring or multiple short ECG-recordings during an extended period. Their relative efficiency is a matter of discussion. In a retrospective cohort study on 994 patients with an ischemic stroke or transient ischemic attack (TIA), we have compared continuous 7-day monitoring to intermittent recording 60 sec three times daily with a handheld device during 3 weeks. We related the result to subsequent occurrence of AF as detected in 12-lead ECG recordings.

Methods: The patients were identified in the local database of cardiovascular investigations. Their clinical profile and vital status during the follow-up were obtained from the Swedish Stroke Register and the Swedish general population registry. For comparison, we used an age- and sex-matched population with no known cerebrovascular event and a population with a cerebrovascular event that was not screened.

Results: AF was detected in 7.1% by continuous screening and in 5.1% by intermittent screening (P = 0.3). During follow-up of 32 months, AF in 12-lead ECG was found in 7.0%. In the subgroup with positive screening, 46.3% had AF compared with 6.7% in the subgroup with negative screening (P < 0.0001).

Conclusions: The two screening approaches had a similar yield of arrhythmia, in spite of the group with intermittent monitoring having a more favorable clinical profile. A positive screening was highly predictive of AF in ECG during the follow-up.

Ort, förlag, år, upplaga, sidor
Upsala Medical Society , 2022. Vol. 127, artikel-id e8318
Nyckelord [en]
Arrhythmia, continuous ECG-monitoring, intermittent ECG-recordings, ischemic stroke, screening, TIA
Nationell ämneskategori
Kardiologi
Identifikatorer
URN: urn:nbn:se:umu:diva-196120DOI: 10.48101/ujms.v127.8318ISI: 000811346800001PubMedID: 35722185Scopus ID: 2-s2.0-85130696110OAI: oai:DiVA.org:umu-196120DiVA, id: diva2:1675551
Tillgänglig från: 2022-06-23 Skapad: 2022-06-23 Senast uppdaterad: 2023-09-05Bibliografiskt granskad

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Pennlert, JohannaKesek, Milos

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