Document Detail


Detection of paroxysmal atrial fibrillation with transtelephonic EKG in TIA or stroke patients.
MedLine Citation:
PMID:  20498434     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Paroxysmal atrial fibrillation (PAF) may remain underdiagnosed after stroke, as suggested by long-duration EKG monitoring. Here we report the sensitivity of transtelephonic EKG monitoring (TTM) for detection of PAF in patients following a recent stroke or TIA and a negative 24-hour Holter. METHODS: We analyzed data from 98 consecutive patients with TTM and noncardioembolic TOAST stroke (n = 78) or TIA (n = 20). Most were cryptogenic events (82%). Patients started TTM 0.8 months (interquartile range 0.4-2.5) after the indexed event and randomly recorded about 1 EKG per day for 1 month. Univariate and multivariate analyses were run to identify PAF predictors. RESULTS: Seventeen PAF episodes were detected in 9.2% (9/98) of the patients. The estimated duration of PAF episodes ranged from 4 to 72 hours. Two predictors were identified: premature atrial ectopic beats (more than 100) in 24-hour routine Holter (odds ratio [OR] = 11.0; 95% confidence interval [CI] 1.9-62; p = 0.007) and nonlacunar anterior circulation DWI hypersignals (OR = 9.9; 95% CI 1.1-90.6; p = 0.04). The PAF detection rate varied from 42.6% for patients meeting both criteria to 0% for patients with neither of them. CONCLUSIONS: Transtelephonic EKG monitoring increases detection rate of paroxysmal atrial fibrillation in stroke and TIA patients whose 24-hour Holter result was negative, especially if they had frequent premature atrial ectopic beats, recent anterior circulation infarct on MRI, or both.
Authors:
N Gaillard; S Deltour; B Vilotijevic; A Hornych; S Crozier; A Leger; R Frank; Y Samson
Related Documents :
18077484 - Characterization of focal right atrial appendage tachycardia.
3716764 - Persistent disturbances of cognitive functions in patients with pseudotumor cerebri.
16321694 - Effects of postural change on oxygen saturation and respiration in patients after the f...
17456134 - Focal atrial tachycardia originating from the left atrial appendage: electrocardiograph...
20082274 - Cutoff value of carcinoembryonic antigen and carbohydrate antigen 19-9 elevation levels...
10745134 - Evaluation of crohn's disease using half-fourier rare and gadolinium-enhanced sge seque...
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Neurology     Volume:  74     ISSN:  1526-632X     ISO Abbreviation:  Neurology     Publication Date:  2010 May 
Date Detail:
Created Date:  2010-05-25     Completed Date:  2010-06-15     Revised Date:  2010-06-29    
Medline Journal Info:
Nlm Unique ID:  0401060     Medline TA:  Neurology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1666-70     Citation Subset:  AIM; IM    
Affiliation:
APHP Urgences C?r?brovasculaires, H?pital Piti?-Salp?tri?re et UMPC Paris Universitas, 75013 Paris, France.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Aged
Atrial Fibrillation / diagnosis*,  etiology*
Electrocardiography / methods*
Female
Humans
Ischemic Attack, Transient / complications*
Logistic Models
Male
Middle Aged
Retrospective Studies
Stroke / complications*
Telemetry / methods*
Comments/Corrections
Comment In:
Neurology. 2010 May 25;74(21):1662-3   [PMID:  20498433 ]
J Neurol. 2010 Jul;257(7):1221-3   [PMID:  20559840 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  New Tests for Prostate Cancer May Be Nearing the Clinic.
Next Document:  Optimal screening strategy for familial intracranial aneurysms: A cost-effectiveness analysis.