Atrial fibrillation in patients with cryptogenic stroke

The New England Journal of Medicine
David J GladstoneEMBRACE Investigators and Coordinators

Abstract

Atrial fibrillation is a leading preventable cause of recurrent stroke for which early detection and treatment are critical. However, paroxysmal atrial fibrillation is often asymptomatic and likely to go undetected and untreated in the routine care of patients with ischemic stroke or transient ischemic attack (TIA). We randomly assigned 572 patients 55 years of age or older, without known atrial fibrillation, who had had a cryptogenic ischemic stroke or TIA within the previous 6 months (cause undetermined after standard tests, including 24-hour electrocardiography [ECG]), to undergo additional noninvasive ambulatory ECG monitoring with either a 30-day event-triggered recorder (intervention group) or a conventional 24-hour monitor (control group). The primary outcome was newly detected atrial fibrillation lasting 30 seconds or longer within 90 days after randomization. Secondary outcomes included episodes of atrial fibrillation lasting 2.5 minutes or longer and anticoagulation status at 90 days. Atrial fibrillation lasting 30 seconds or longer was detected in 45 of 280 patients (16.1%) in the intervention group, as compared with 9 of 277 (3.2%) in the control group (absolute difference, 12.9 percentage points; 95% confidence int...Continue Reading

References

Nov 29, 1990·The New England Journal of Medicine·UNKNOWN Boston Area Anticoagulation Trial for Atrial Fibrillation InvestigatorsJ Philip Kistler
Aug 8, 2007·Neurology·UNKNOWN Stroke Risk in Atrial Fibrillation Working Group
Sep 28, 2007·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Paulus KirchhofGünter Breithardt
Feb 1, 2008·Annals of Noninvasive Electrocardiology : the Official Journal of the International Society for Holter and Noninvasive Electrocardiology, Inc·Hans D EspererRichard J Cohen
Sep 2, 2008·Stroke; a Journal of Cerebral Circulation·David J GladstoneMoira K Kapral
May 29, 2010·Stroke; a Journal of Cerebral Circulation·Hooman KamelS Claiborne Johnston
Feb 12, 2011·The New England Journal of Medicine·Stuart J ConnollyUNKNOWN AVERROES Steering Committee and Investigators
May 7, 2011·Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association·Hooman KamelS Claiborne Johnston
Jan 13, 2012·The New England Journal of Medicine·Jeff S HealeyUNKNOWN ASSERT Investigators
Apr 17, 2012·The American Journal of Cardiology·A John CammLuigi Padeletti
Oct 4, 2012·Stroke; a Journal of Cerebral Circulation·Simerpreet BalShelagh B Coutts
Nov 22, 2012·Stroke; a Journal of Cerebral Circulation·Gustavo SaposnikUNKNOWN Investigators of the Registry of the Canadian Stroke Network (RCSN) and the Stroke Outcomes Research Canada (SORCan) Working
Apr 19, 2013·European Heart Journal·Sana M Al-KhatibChristopher B Granger
Jun 29, 2013·The Canadian Journal of Cardiology·Taya V Glotzer, Paul D Ziegler
Jun 25, 2013·Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association·Alejandro A RabinsteinPaul A Friedman
Aug 1, 2013·Stroke; a Journal of Cerebral Circulation·Peter HigginsKennedy R Lees
Mar 19, 2014·Circulation·Michela BrambattiUNKNOWN ASSERT Investigators
Mar 22, 2014·Lancet Neurology·Robert G HartUNKNOWN Cryptogenic Stroke/ESUS International Working Group

❮ Previous
Next ❯

Citations

Sep 25, 2014·The New England Journal of Medicine·David J GladstoneUNKNOWN EMBRACE Steering Committee and Investigators
Dec 3, 2014·Cardiology Clinics·Patrick Dillon, Hamid Ghanbari
Dec 4, 2014·European Journal of Internal Medicine·Ami Schattner, Aviel Hadad
Feb 14, 2016·European Heart Journal·Sanjeev P BhavnaniPartho P Sengupta
Oct 22, 2015·Expert Review of Cardiovascular Therapy·Jonathan M Wong, Mark Fisher
Jan 4, 2015·Expert Review of Cardiovascular Therapy·Alessio Lilli, Andrea Di Cori
May 4, 2015·Heart·Joseph Walker KeachThomas M Maddox
Feb 5, 2016·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Chu-Pak LauHung-Fat Tse
Oct 21, 2015·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Paulus KirchhofA John Camm
Nov 4, 2016·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Christine Benn ChristiansenChristian Torp-Pedersen
Oct 17, 2015·European Journal of Neurology : the Official Journal of the European Federation of Neurological Societies·S PoliC S Zuern
Dec 15, 2015·European Journal of Neurology : the Official Journal of the European Federation of Neurological Societies·D J Miller
Dec 9, 2014·Neurologia i neurochirurgia polska·Monika Gołąb-JanowskaPrzemysław Nowacki
Mar 7, 2015·Circulation Journal : Official Journal of the Japanese Circulation Society·Marc Fisher, Mark McAllister
Sep 22, 2015·Journal of Hospital Medicine : an Official Publication of the Society of Hospital Medicine·S Andrew Josephson
Jan 24, 2015·Journal of the American College of Cardiology·Carol Chen-ScarabelliJonathan L Halperin
Nov 3, 2015·Annals of Noninvasive Electrocardiology : the Official Journal of the International Society for Holter and Noninvasive Electrocardiology, Inc·David M GermanLarisa G Tereshchenko
Jan 24, 2016·The American Journal of the Medical Sciences·Doungporn RuthiragoKenneth Nugent
Oct 20, 2015·Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association·Shadi YaghiMitchell S V Elkind
Nov 9, 2015·International Journal of Cardiology·Willem J VerberkGeorge S Stergiou
Oct 23, 2015·International Journal of Cardiology·R FerrariG G Vicedomini
Mar 13, 2016·Heart Failure Clinics·Patrick Dillon, Hamid Ghanbari
Jul 7, 2015·International Journal of Stroke : Official Journal of the International Stroke Society·Luciano A SposatoGustavo Saposnik
Jul 17, 2015·International Journal of Stroke : Official Journal of the International Stroke Society·Robert G HartAshkan Shoamanesh
May 7, 2016·Cardiology Clinics·Sukit M RingwalaRod S Passman
Feb 20, 2016·Expert Review of Cardiovascular Therapy·R ProiettiA Verma
Oct 16, 2015·Neurology·Shadi Yaghi, Mitchell S V Elkind
May 7, 2016·Cardiology Clinics·Francesca PistoiaAntonio Carolei
Jan 20, 2015·European Journal of Neurology : the Official Journal of the European Federation of Neurological Societies·A C Fonseca, J M Ferro
Jun 24, 2015·Journal of Cardiovascular Electrophysiology·Jorge RomeroLuigi DI Biase
Jul 15, 2015·Pacing and Clinical Electrophysiology : PACE·Muhammad R AfzalDhanunjaya Lakkireddy
Jun 3, 2015·Annals of Emergency Medicine·Dustin W BallardUNKNOWN KP Crest Network Investigators
Apr 16, 2015·Neurological Research·J David Spence
Oct 7, 2014·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Taya V Glotzer, Paul D Ziegler
Jul 18, 2015·Journal of the American College of Cardiology·Bjørn Strøier LarsenAhmad Sajadieh
Aug 15, 2015·Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association·Hyemoon ChungJong-Youn Kim
Jul 21, 2015·Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association·Kotaro YoshiokaHidehiro Mizusawa
Jul 15, 2015·European Journal of Internal Medicine·V Thijs, K Butcher

❮ Previous
Next ❯

Related Concepts

Related Feeds

Brain Ischemia

Brain ischemia is a condition in which there is insufficient blood flow to the brain to meet metabolic demand. Discover the latest research on brain ischemia here.

Arrhythmia

Arrhythmias are abnormalities in heart rhythms, which can be either too fast or too slow. They can result from abnormalities of the initiation of an impulse or impulse conduction or a combination of both. Here is the latest research on arrhythmias.

Atrial Fibrillation

Atrial fibrillation is a common arrhythmia that is associated with substantial morbidity and mortality, particularly due to stroke and thromboembolism. Here is the latest research.

Atrial Filbrillation

Atrial fibrillation refers to the abnormal heart rhythm characterized by rapid and irregular beating of the atria. Here is the latest research.