Paroxysmal atrial fibrillation occurs often in cryptogenic ischaemic stroke: Final results from the SURPRISE study
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Paroxysmal atrial fibrillation occurs often in cryptogenic ischaemic stroke : Final results from the SURPRISE study. / Christensen, L M; Krieger, D W; Højberg, S; Pedersen, O D; Karlsen, F M; Jacobsen, M D; Worck, R; Nielsen, H; Aegidius, K; Jeppesen, L L; Rosenbaum, S; Marstrand, J; Christensen, H.
I: European journal of neurology : the official journal of the European Federation of Neurological Societies, Bind 21, Nr. 6, 06.2014, s. 884-889.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Paroxysmal atrial fibrillation occurs often in cryptogenic ischaemic stroke
T2 - Final results from the SURPRISE study
AU - Christensen, L M
AU - Krieger, D W
AU - Højberg, S
AU - Pedersen, O D
AU - Karlsen, F M
AU - Jacobsen, M D
AU - Worck, R
AU - Nielsen, H
AU - Aegidius, K
AU - Jeppesen, L L
AU - Rosenbaum, S
AU - Marstrand, J
AU - Christensen, H
N1 - © 2014 The Author(s) European Journal of Neurology © 2014 EAN.
PY - 2014/6
Y1 - 2014/6
N2 - BACKGROUND AND PURPOSE: Atrial fibrillation (AF) increases the risk of stroke fourfold and is associated with a poor clinical outcome. Despite work-up in compliance with guidelines, up to one-third of patients have cryptogenic stroke (CS). The prevalence of asymptomatic paroxysmal atrial fibrillation (PAF) in CS remains unknown. The SURPRISE project aimed at determining this rate using long-term cardiac monitoring.METHODS: Patients with CS after protocolled work-up including electrocardiography (ECG) and telemetry were included after informed consent. An implantable loop recorder (ILR) was implanted subcutaneously. PAF was defined by events of atrial arrhythmia >2 min with a correlating one-lead ECG confirming the diagnosis.RESULTS: Eighty-five patients were monitored for a mean of 569 days (SD ±310). PAF was documented in 18 patients (20.7%) during the study period and detected by ILR in 14 patients (16.1%). In three patients PAF was detected by other methods before or after monitoring and was undiscovered due to device sensitivity in one case. The first event of PAF was documented at a mean of 109 days (SD ±48) after stroke onset. PAF was asymptomatic in all cases and occurred in episodes lasting predominantly between 1 and 4 h. Four recurrent strokes were observed, three in patients with PAF; all three patients were on oral anticoagulation (OAC).CONCLUSIONS: One in five patients with CS had PAF, which occurred at low burden and long after stroke. Future studies should determine the role of implantable cardiac monitors after stroke and determine the potential therapeutic benefit of OAC treatment of patients with PAF.
AB - BACKGROUND AND PURPOSE: Atrial fibrillation (AF) increases the risk of stroke fourfold and is associated with a poor clinical outcome. Despite work-up in compliance with guidelines, up to one-third of patients have cryptogenic stroke (CS). The prevalence of asymptomatic paroxysmal atrial fibrillation (PAF) in CS remains unknown. The SURPRISE project aimed at determining this rate using long-term cardiac monitoring.METHODS: Patients with CS after protocolled work-up including electrocardiography (ECG) and telemetry were included after informed consent. An implantable loop recorder (ILR) was implanted subcutaneously. PAF was defined by events of atrial arrhythmia >2 min with a correlating one-lead ECG confirming the diagnosis.RESULTS: Eighty-five patients were monitored for a mean of 569 days (SD ±310). PAF was documented in 18 patients (20.7%) during the study period and detected by ILR in 14 patients (16.1%). In three patients PAF was detected by other methods before or after monitoring and was undiscovered due to device sensitivity in one case. The first event of PAF was documented at a mean of 109 days (SD ±48) after stroke onset. PAF was asymptomatic in all cases and occurred in episodes lasting predominantly between 1 and 4 h. Four recurrent strokes were observed, three in patients with PAF; all three patients were on oral anticoagulation (OAC).CONCLUSIONS: One in five patients with CS had PAF, which occurred at low burden and long after stroke. Future studies should determine the role of implantable cardiac monitors after stroke and determine the potential therapeutic benefit of OAC treatment of patients with PAF.
KW - Aged
KW - Atrial Fibrillation
KW - Brain Ischemia
KW - Electrocardiography
KW - Female
KW - Humans
KW - Male
KW - Middle Aged
KW - Stroke
U2 - 10.1111/ene.12400
DO - 10.1111/ene.12400
M3 - Journal article
C2 - 24628954
VL - 21
SP - 884
EP - 889
JO - European Journal of Neurology
JF - European Journal of Neurology
SN - 1351-5101
IS - 6
ER -
ID: 137428648