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Occult paroxysmal atrial fibrillation in non-cryptogenic ischemic stroke.

Abstract：

OBJECTIVE:To determine the prevalence and risk factors for paroxysmal atrial fibrillation (PAF) diagnosis in non- cryptogenic ischemic stroke (CIS) patients. METHODS:In this pilot-prospective cohort study of non-CIS patients from September 2014 to September 2017, 53 patients were enrolled. 51/53 patients were implanted within 10 days of stroke onset with the Reveal LINQ insertable cardiac monitor and monitored until PAF detection or a minimum of 12 months. Inclusion required diagnosis of a non-AF stroke etiology, age ≥ 40, and either a virtual CHADS2 score ≥ 3 or ≥ 2 PAF-related comorbidities. RESULTS:Over a median monitoring period of 398 days, PAF was detected in 6/51 (11.8%) patients and anticoagulation was initiated in 5/6 (83.3%). Median time to PAF detection was 87 days (range 0-356 days). Median longest PAF episode was 96 min (range 1 to 1122 min), and 4/6 had multiple PAF recordings. Mean left atrial volume index was significantly higher in PAF patients (31.0 vs. 23.2 cc/m2; p = 0.04). CONCLUSION:Long-term monitoring of non-CIS patients detected PAF in a clinically relevant proportion of patients, resulting in stroke prevention therapy optimization. Further study to confirm these findings and refine the subset that would benefit from long-term cardiac monitoring is warranted.

journal_name

J Neurol

journal_title

Journal of neurology

authors

Katz JM,Eng MS,Carrazco C,Patel AV,Jadonath R,Gribko M,Arora R,Libman RB

doi

10.1007/s00415-018-8982-9

subject

Has Abstract

pub_date

2018-10-01 00:00:00

pages

2237-2242

issue

10

eissn

0340-5354

issn

1432-1459

pii

10.1007/s00415-018-8982-9

journal_volume

265

pub_type

临床试验,杂志文章

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