Atrial Fibrillation and Premature Atrial Complexes in Patients With Ischemic Stroke.

Study Overview
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Brief Summary
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The purpose of this study is to improve secondary prevention of ischemic stroke patients by Estimating prevalence and the prognostic significance of frequent premature atrial complexes in ischemic stroke patients in relation to death, recurrent stroke and atrial fibrillation. Characterize ischemic stroke patients by Echocardiographic characteristics Biochemical markers Plaque composition in the carotid arteries in order to improve risk stratification.

Detailed Description
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Patients with atrial fibrillation (AF) have a five-fold increased risk of ischemic stroke compared to the general population. Identifying AF can be challenging, but prolonged rhythm monitoring of ischemic stroke patients have shown to enhance detection rates of AF. Therefore it is important to identify predictors of AF to allow targeted screening of patients after ischemic stroke and thereby reduce the recurrent stroke rate. Few former studies have shown an association between excessive numbers of premature atrial complexes (PACs) and AF. The study population of ischemic stroke patients will at admission undergo following examinations: ECG 48 hours inpatient cardiac telemetry (If not known AF) 24 hours holter monitoring (if not known AF) echocardiogram blood sample CT scan of carotid arteries with contrast made on Dual Energy CT scan. In the follow-up period, patients will have two visits with 48 hour holter monitoring (after 6 and 12 months, respectively) It will be noticed if patients have any recurrent events, die og developing AF. The study population will be divided into four groups as follows: patients with new AF at admission patients with known AF patients with frequent PACs patients without frequent PACs. These groups will be compared on baseline characteristics and on outcome as mentioned. The overall perspective is to make better strategies for detecting occult AF after ischemic stroke to improve secondary stroke prevention care.

Official Title
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Atrial Fibrillation and Premature Atrial Complexes in Patients With Ischemic Stroke: Prevalence, Characteristics and Prognosis

Conditions
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Stroke, Atrial Fibrillation, Premature Atrial Complexes

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: admitted with ischemic stroke at a single center time from diagnose to inclusion maximum 7 days. written informed consent or surrogate informed consent eligible age > 18 years. Exclusion Criteria: hemorrhagic stroke terminal illness and expected lifespan of less than 6 months. any physical or mental condition which make the patients unsuitable for participation in the study. known with a pacemaker anticoagulation treatment of other reasons than atrial fibrillation.

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Ischemic stroke patients<br>Patients admitted with ischemic stroke from march 2012 to april 2014 | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| time to death and recurrent stroke |  | Up to 4 years | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Time to death, recurrent stroke and atrial fibrillation |  | Up to 4 years | 
| Left atrial volume and function estimated by echocardiography | descriptive comparison in between groups. | baseline | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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stroke, Ischemic stroke, Cerebral infarction, recurrent stroke, atrial fibrillation, premature atrial complexes, heart rhythm monitoring, left atrial function, carotid artery, plaque morphology