Electrocardiographic monitoring for detecting atrial fibrillation after ischemic stroke or transient ischemic attack

Charles Dussault*, Hadi Daood Toeg, Meena Nathan, Zhi Jian Wang, Jean Francois Roux, Eric Secemsky

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

46 Scopus citations

Abstract

Background-Atrial fibrillation (AF) is a major cause of stroke. Although standard investigations after an event include electrocardiographic monitoring, the optimal duration to detect AF is unclear. We performed a systematic review and meta-analysis to determine whether the duration of electrocardiographic monitoring after an ischemic event is related to the detection of AF. Methods and Results-Prospective studies that reported the proportion of new AF diagnosed using electrocardiographic monitoring for >12 hours in patients with recent stroke or transient ischemic attack were analyzed. Studies were excluded if the stroke was hemorrhagic or AF was previously diagnosed. A total of 31 articles met inclusion criteria. Longer duration of monitoring was associated with an increased detection of AF when examining monitoring time as a continuous variable (P<0.001 for metaregression analysis). When dichotomizing studies based on monitoring duration, studies with monitoring lasting ≤72 hours detected AF in 5.1%, whereas monitoring lasting ≥7 days detected AF in 15%. The proportion of new diagnosis increased to 29.15% with extended monitoring for 3 months. Significant heterogeneity within studies was detected for both groups (≤72 hours, I 2 =91.3%; ≥7 days, I 2 =75.8). When assessing the odds of AF detection in the 3 randomized controlled trial, there was a 7.26 increased odds of AF with long-term monitoring (95% confidence intervals [3.99-12.83]; P value <0.001). Conclusions-Longer duration of electrocardiographic monitoring after cryptogenic stroke is associated with a greater detection of AF. Future investigation is needed to determine the optimal duration of long-term monitoring.

Original languageEnglish (US)
Pages (from-to)263-269
Number of pages7
JournalCirculation: Arrhythmia and Electrophysiology
Volume8
Issue number2
DOIs
StatePublished - Apr 20 2015

Keywords

  • atrial fibrillation
  • electrocardiography
  • meta-analysis
  • stroke

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Fingerprint Dive into the research topics of 'Electrocardiographic monitoring for detecting atrial fibrillation after ischemic stroke or transient ischemic attack'. Together they form a unique fingerprint.

Cite this