Detection of atrial fibrillation with concurrent holter monitoring and continuous cardiac telemetry following ischemic stroke and transient ischemic attack. J Stroke Cerebrovasc Dis 2012 Feb;21(2):89-93
Date
07/27/2010Pubmed ID
20656504DOI
10.1016/j.jstrokecerebrovasdis.2010.05.006Scopus ID
2-s2.0-84856492403 (requires institutional sign-in at Scopus site) 70 CitationsAbstract
Atrial fibrillation (AF) is a major risk factor for recurrent ischemic stroke. We aimed to compare the detection rate of AF using continuous cardiac telemetry (CCT) versus Holter monitoring in hospitalized patients with ischemic stroke or transient ischemic attack (TIA). Between June 2007 and December 2008, 133 patients were admitted to an academic institution for ischemic stroke or TIA and underwent concurrent inpatient CCT and Holter monitoring. Rates of AF detection by CCT and Holter monitoring were compared using the McNemar paired proportion test. Among the 133 patients, 8 (6.0%) were diagnosed with new-onset AF. On average, Holter monitoring was performed for 29.8 hours, and CCT was performed for 73.6 hours. The overall rate of AF detection was higher for Holter monitoring compared with CCT (6.0%; 95% confidence interval [CI], 2.9-11.6 vs 0; 95% CI, 0-3.4; P = .008). Holter detection of AF was even higher in specific subgroups (those with an embolic infarct pattern, those age >65 years, and those with coronary artery disease). Holter monitoring detected AF in 6% of hospitalized ischemic stroke and TIA patients, with higher proportions in high-risk subgroups. Compared with CCT, Holter monitoring is significantly more likely to detect arrhythmias.
Author List
Lazzaro MA, Krishnan K, Prabhakaran SAuthor
Marc A. Lazzaro MD Associate Professor in the Neurology department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AgedAtrial Fibrillation
Brain Ischemia
Chicago
Electrocardiography, Ambulatory
Female
Hospitalization
Humans
Ischemic Attack, Transient
Male
Middle Aged
Predictive Value of Tests
Recurrence
Registries
Risk Assessment
Risk Factors
Stroke
Telemetry
Time Factors
