Relevance of supraventricular runs detected after cerebral ischemia

Weber-Krueger, Mark and Lutz, Constanze and Zapf, Antonia and Stahrenberg, Raoul and Seegers, Joachim and Witzenhausen, Janin and Wasser, Katrin and Hasenfuss, Gerd and Groeschel, Klaus and Wachter, Rolf (2017) Relevance of supraventricular runs detected after cerebral ischemia. NEUROLOGY, 89 (15). pp. 1545-1552. ISSN 0028-3878, 1526-632X

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Abstract

Objective: Prolonged ECG monitoring after stroke frequently reveals short paroxysmal atrial fibrillation (pAF) and supraventricular (SV) runs. The minimal duration of atrial fibrillation (AF) required to induce cardioembolism, the relevance of SV runs, and whether short pAF results from cerebral damage itself are currently being debated. We aimed to study the relevance of SV runs and short pAF detected by prolonged Holter ECG after cerebral ischemia during long-term follow-up. Methods: Analysis is from the prospective Find-AF trial (ISRCTN46104198). We included patients with acute cerebral ischemia. Those without AF on admission received 7-day Holter ECG monitoring. We differentiated patients with AF on admission (AF-adm), with pAF (>30 seconds), with SV runs (>5 beats but <30 seconds in a 24-hour ECG interval), and without SV runs (controls). During follow-up, those with baseline pAF received another 7-day Holter ECG to examine AF persistence. Results: A total of 254 of 281 initially included patients were analyzed (mean age 70.0 years, 45.3% female). Forty-three (16.9%) had AF-adm. A total of 211 received 7-day Holter ECG monitoring: 27 (12.8%) had pAF, 67 (31.8%) had SV runs, and 117 (55.5%) were controls. During a mean 3.7 years of follow-up, the SV runs group had more recurrent strokes (p = 0.04) and showed numerically more novel AF (12% vs 5%, p = 0.09) than the controls. Seventy-five percent of the patients with manifest pAF detected after cerebral ischemia still had AF during follow-up (50% paroxysmal, 50% persisting/permanent). Conclusions: Patients with cerebral ischemia and SV runs had more recurrent strokes and numerically more novel AF during follow-up and could benefit from further prolonged ECG monitoring. pAF detected after stroke is not a temporal phenomenon.

Item Type: Article
Uncontrolled Keywords: SUBCLINICAL ATRIAL-FIBRILLATION; STROKE; RISK; ARRHYTHMIA; MECHANISMS; ATTACK;
Subjects: 600 Technology > 610 Medical sciences Medicine
Divisions: Medicine > Lehrstuhl für Innere Medizin II
Depositing User: Dr. Gernot Deinzer
Date Deposited: 14 Dec 2018 13:19
Last Modified: 28 Feb 2019 14:52
URI: https://pred.uni-regensburg.de/id/eprint/2011

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