| Detection of paroxysmal atrial fibrillation with transtelephonic EKG in TIA or stroke patients. | |
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MedLine Citation:
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PMID: 20498434 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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N Gaillard; S Deltour; B Vilotijevic; A Hornych; S Crozier; A Leger; R Frank; Y Samson |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Neurology Volume: 74 ISSN: 1526-632X ISO Abbreviation: Neurology Publication Date: 2010 May |
Date Detail:
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Created Date: 2010-05-25 Completed Date: 2010-06-15 Revised Date: 2010-06-29 |
Medline Journal Info:
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Nlm Unique ID: 0401060 Medline TA: Neurology Country: United States |
Other Details:
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Languages: eng Pagination: 1666-70 Citation Subset: AIM; IM |
Affiliation:
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APHP Urgences C?r?brovasculaires, H?pital Piti?-Salp?tri?re et UMPC Paris Universitas, 75013 Paris, France. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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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:
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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
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