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 .
Detection of paroxysmal atrial fibrillation with transtelephonic EKG in TIA or stroke patients
Background : Paroxysmal atrial fibrillation ( PAF ) may remain underdiagnosed after stroke , as suggested by long- duration EKG monitoring . Here we report the sensitivity of transtelephonic EKG monitoring ( TTM ) for detection of PAF in patients following a recent stroke or TIA and a negative 24-hour Holter . Methods : We analyzed data from 98 consecutive patients with TTM and noncardioembolic TOAST stroke ( n = 78 ) or TIA ( n = 20 ) . Most were cryptogenic events ( 82 % ) . Patients started TTM 0.8 months ( interquartile range 0.4–2.5 ) after the indexed event and r and omly recorded about 1 EKG per day for 1 month . Univariate and multivariate analyses were run to identify PAF predictors . Results : Seventeen PAF episodes were detected in 9.2 % ( 9/98 ) of the patients . The estimated duration of PAF episodes ranged from 4 to 72 hours . Two predictors were identified : premature atrial ectopic beats ( more than 100 ) in 24-hour routine Holter ( odds ratio [ OR ] = 11.0 ; 95 % confidence interval [ CI ] 1.9–62 ; p = 0.007 ) and nonlacunar anterior circulation DWI hypersignals ( OR = 9.9 ; 95 % CI 1.1–90.6 ; p = 0.04 ) . The PAF detection rate varied from 42.6 % for patients meeting both criteria to 0 % for patients with neither of them . Conclusions : Transtelephonic EKG monitoring increases detection rate of paroxysmal atrial fibrillation in stroke and TIA patients whose 24-hour Holter result was negative , especially if they had frequent premature atrial ectopic beats , recent anterior circulation infa rct on MRI , or both
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 .