Relevance of supraventricular runs detected after cerebral ischemia
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Relevance of supraventricular runs detected after cerebral ischemia. / Weber-Krüger, Mark; Lutz, Constanze; Zapf, Antonia; Stahrenberg, Raoul; Seegers, Joachim; Witzenhausen, Janin; Wasser, Katrin; Hasenfuß, Gerd; Gröschel, Klaus; Wachter, Rolf.
In: NEUROLOGY, Vol. 89, No. 15, 10.10.2017, p. 1545-1552.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Relevance of supraventricular runs detected after cerebral ischemia
AU - Weber-Krüger, Mark
AU - Lutz, Constanze
AU - Zapf, Antonia
AU - Stahrenberg, Raoul
AU - Seegers, Joachim
AU - Witzenhausen, Janin
AU - Wasser, Katrin
AU - Hasenfuß, Gerd
AU - Gröschel, Klaus
AU - Wachter, Rolf
N1 - © 2017 American Academy of Neurology.
PY - 2017/10/10
Y1 - 2017/10/10
N2 - 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.
AB - 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.
KW - Aged
KW - Aged, 80 and over
KW - Atrial Fibrillation
KW - Brain Ischemia
KW - Electrocardiography
KW - Electrocardiography, Ambulatory
KW - Female
KW - Follow-Up Studies
KW - Humans
KW - Kaplan-Meier Estimate
KW - Male
KW - Middle Aged
KW - Prospective Studies
KW - Severity of Illness Index
KW - Tachycardia, Ectopic Atrial
KW - Time Factors
KW - Journal Article
U2 - 10.1212/WNL.0000000000004487
DO - 10.1212/WNL.0000000000004487
M3 - SCORING: Journal article
C2 - 28904084
VL - 89
SP - 1545
EP - 1552
JO - NEUROLOGY
JF - NEUROLOGY
SN - 0028-3878
IS - 15
ER -