Automatic detection of paroxysmal atrial fibrillation in patients with ischaemic stroke: better than routine diagnostic workup?

European Journal of Neurology : the Official Journal of the European Federation of Neurological Societies
T UphausKlaus Gröschel

Abstract

Prolonged electrocardiogram (ECG) monitoring after ischaemic stroke increases the diagnostic yield of paroxysmal atrial fibrillation (pAF). In order to facilitate the additional workload involved in ECG analysis due to prolonged monitoring times, we investigated the effectiveness of pAF detection with an automated software algorithm (SA) in comparison to the routine staff-based analysis (RA) during standard stroke-unit care. Therefore, patients with acute ischaemic stroke or transitory ischaemic attack presenting with sinus rhythmus on the admission ECG and no history of atrial fibrillation were prospectively included. A 24-h Holter ECG assessment was performed using either RA based on a computer-aided evaluation and subsequent review by a cardiologist or a commercially available automated SA. In the case of discordant results concerning the occurrence of pAF between the two methods, the data underwent an independent external rating. Of 809 prospectively enrolled patients, 580 patients fulfilled the inclusion criteria. pAF was ultimately diagnosed in 3.3% of the cohort (19 patients). SA and RA correctly diagnosed pAF in 17 patients resulting in a comparable diagnostic effectiveness of the analysis methods (sensitivity: SA 89.5%...Continue Reading

References

May 29, 2013·European Journal of Neurology : the Official Journal of the European Federation of Neurological Societies·J WohlfahrtK Gröschel
Aug 1, 2013·Stroke; a Journal of Cerebral Circulation·Peter HigginsKennedy R Lees
Aug 12, 2015·European Journal of Neurology : the Official Journal of the European Federation of Neurological Societies·A PalomäkiK E J Airaksinen
Oct 17, 2015·European Journal of Neurology : the Official Journal of the European Federation of Neurological Societies·S PoliC S Zuern
Feb 12, 2017·Lancet Neurology·Rolf WachterUNKNOWN Find-AF(randomised) Investigators and Coordinators

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Citations

Apr 29, 2018·Clinical Research in Cardiology : Official Journal of the German Cardiac Society·Karl Georg HaeuslerRenate Schnabel
Oct 23, 2018·European Journal of Neurology : the Official Journal of the European Federation of Neurological Societies·A H V Schapira
Apr 13, 2020·European Journal of Neurology : the Official Journal of the European Federation of Neurological Societies·S GröschelT Uphaus
Aug 31, 2020·Annals of Clinical and Translational Neurology·Sonja GröschelTimo Uphaus
Dec 18, 2019·Stroke; a Journal of Cerebral Circulation·Meritxell GomisCarlos Molina
Aug 10, 2018·Current Neurology and Neuroscience Reports·Karl Georg HaeuslerRenate B Schnabel
Feb 19, 2021·Herz·H C Diener, R Wachter

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