Prevalence and Predictors of Paroxysmal Atrial Fibrillation on Holter Monitor in Patients With Stroke or Transient Ischemic Attack
- 1 November 2010
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Stroke
- Vol. 41 (11), 2596-2600
- https://doi.org/10.1161/strokeaha.109.570382
Abstract
Background and Purpose— Our aims were to quantify the yield of Holter monitor for detection of paroxysmal atrial fibrillation (PAF) in patients with stroke and TIA, and to determine potential predictors of PAF to allow more focused testing. Methods— We reviewed records of 1128 consecutive patients attending a university stroke clinic from September 2005 to September 2006 and identified 426 patients with definite TIA or stroke. We abstracted clinical, cardiac imaging, and neuroimaging data. Logistic regression analysis was performed to determine independent predictors of PAF on Holter monitor. Results— Overall, 413 of 426 patients (65±15 years; male, 49.8%) with a definite TIA (53%) or stroke (47%) underwent Holter monitoring for a mean of 22.6 hours. PAF occurred in 39 patients (9.2%) all older than age 55 years. PAF lasting >30 seconds was evident in 11 patients (2.5%). The other 28 patients had PAF P =0.0047) and chronic (OR, 1.6 for each 1 lesion increase; 95% CI, 1.2–2.3; P =0.0001) infarcts on brain CT, number of chronic infarcts on MRI (OR, 3.0 for each 1 lesion increase; 95% CI, 1.7–5.1; P P =0.0023) were associated with PAF. Conclusions— PAF is present in 9.2% of patients with definite stroke or TIA. Age older than 55 years and presence of acute or chronic brain infarcts on neuroimaging are strongly associated with PAF.Keywords
This publication has 21 references indexed in Scilit:
- Serial Electrocardiographic Assessments Significantly Improve Detection of Atrial Fibrillation 2.6-Fold in Patients With Acute StrokeStroke, 2008
- Noninvasive Cardiac Monitoring for Detecting Paroxysmal Atrial Fibrillation or Flutter After Acute Ischemic StrokeStroke, 2007
- Usefulness of Cardiovascular Investigations in Stroke ManagementStroke, 2007
- Differential Prognosis of Isolated Cortical Swelling and Hypoattenuation on CT in Acute StrokeStroke, 2007
- ACC/AHA/ESC 2006 Guidelines for the Management of Patients With Atrial FibrillationCirculation, 2006
- Poststroke DementiaCerebrovascular Diseases, 2006
- Prevalence of atrial fibrillation in elderly subjects (the Cardiovascular Health Study)The American Journal of Cardiology, 1994
- Significance of atrial fibrillation as a precursor of embolismThe American Journal of Cardiology, 1989
- Coronary heart disease and atrial fibrillation: The Framingham StudyAmerican Heart Journal, 1983
- Clinical features of paroxysmal atrial fibrillation an observation of 94 patients.Japanese Heart Journal, 1981