Longer duration of electrocardiographic monitoring after cryptogenic stroke is associated with a greater detection of AF .
BACKGROUND Atrial fibrillation ( AF ) is a major cause of stroke .
Although st and ard investigations after an event include electrocardiographic monitoring , the optimal duration to detect AF is unclear .
We performed a systematic review and meta- analysis to determine whether the duration of electrocardiographic monitoring after an ischemic event is related to the detection of AF .
Frequent Atrial Premature Beats Predict Paroxysmal Atrial Fibrillation in Stroke Patients: An Opportunity for a New Diagnostic Strategy
Background and Purpose — For patients having suffered ischemic stroke , the current diagnostic strategies often fail to detect atrial fibrillation as a potential cause of embolic events . The aim of the study was to identify paroxysmal atrial fibrillation in stroke patients . We hypothesized that patients with frequent atrial premature beats ( APBs ) recorded in 24-hour ECG will show more often atrial fibrillation when followed by repeated long-term ECG recordings than patients without or infrequent APBs . Methods — 127 patients with acute ischemic stroke and without known AF were enrolled in a prospect i ve study to detect paroxysmal AF . Patients were stratified according to the number of APBs recorded in a 24-hour ECG ( ≥70 APBs versus < 70 APBs ) . Subsequently , they all underwent serial 7-day event-recorder monitoring at 0 , 3 , and 6 months . Results — Serial extended ECG monitoring  identified AF in 26 % of patients with frequent APBs but only in 6.5 % when APBs were infrequent ( P=0.0021 ) . A multivariate analysis showed that the presence of frequent APBs in the initial 24-hour ECG was the only independent predictor of paroxysmal AF during follow-up ( odds ratio 6.6 , 95 % confidence intervals 1.6 to 28.2 , P=0.01 ) . Conclusions — In patients with acute ischemic stroke , frequent APBs ( ≥70/24 hours ) are a marker for individuals who are at greater risk to develop or have paroxysmal AF . For such patients , we propose a diagnostic workup with repeated prolonged ECG monitoring to diagnose paroxysmal AF
Longer duration of electrocardiographic monitoring after cryptogenic stroke is associated with a greater detection of AF .
BACKGROUND Atrial fibrillation ( AF ) is a major cause of stroke .
Although st and ard investigations after an event include electrocardiographic monitoring , the optimal duration to detect AF is unclear .
We performed a systematic review and meta- analysis to determine whether the duration of electrocardiographic monitoring after an ischemic event is related to the detection of AF .