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Prediction of atrial fibrillation after ischemic stroke using P-wave signal averaged electrocardiography.
MedLine Citation:
PMID:  23159211     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: Atrial fibrillation (AF) is highly prevalent in patients with ischemic stroke, but the diagnosis is often difficult. METHODS: This study consisted of 68 stroke patients in sinus rhythm without history of AF. All patients underwent P-wave signal-averaged electrocardiography (P-SAECG), echocardiography, 24-h Holter monitoring, and measurement of plasma B-type natriuretic peptide (BNP) concentrations at admission. RESULTS: An abnormal P-SAECG was found in 34 of 68 stroke patients. In the follow-up period of 11±4 months, AF developed in 17 patients (AF group). The remaining 51 patients were classified as the non-AF group. The prevalence of atrial late potentials (ALP) on P-SAECG, and the number of premature atrial contractions (PACs) were significantly higher in the AF group than those in the non-AF group (88.2% vs 37.3%; p<0.001, 149±120 vs 79±69; p=0.030, respectively). However, there were no significant differences in age, left atrial dimension, or BNP concentrations between both groups. Cox proportional hazards analysis revealed that the presence of ALP (risk ratio 11.15; p=0.002) and frequent PACs (more than 100/24h) (risk ratio 4.53; p=0.007) had significant correlation to the occurrence of AF. CONCLUSIONS: ALP may be a novel predictor of AF in stroke patients. P-SAECG should be considered in stroke of undetermined etiology.
Authors:
Kenji Yodogawa; Yoshihiko Seino; Toshihiko Ohara; Meiso Hayashi; Yasushi Miyauchi; Takao Katoh; Kyoichi Mizuno
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-11-15
Journal Detail:
Title:  Journal of cardiology     Volume:  -     ISSN:  1876-4738     ISO Abbreviation:  J Cardiol     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-11-19     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8804703     Medline TA:  J Cardiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.
Affiliation:
Division of Cardiology, Hepatology, Geriatrics, and Integrated Medicine, Department of Internal Medicine, Nippon Medical School, Tokyo 113-8603, Japan. Electronic address: yodo@nms.ac.jp.
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