ECG Monitoring Ups A-Fib Detection After Stroke
(HealthDay News) — For patients with ischemic stroke or transient ischemic attack, electrocardiogram (ECG) monitoring with a 30-day event-triggered recorder improves detection of atrial fibrillation, according to a study published June 26 in the New England Journal of Medicine.
David J. Gladstone, MD, PhD, from the University of Toronto in Canada, and colleagues conducted a randomized trial to examine the presence of paroxysmal atrial fibrillation in patients with cryptogenic ischemic stroke or transient ischemic attack. A total of 572 patients, aged ≥55 years, without known atrial fibrillation, were randomized to undergo additional noninvasive ambulatory ECG monitoring with a 30-day event-triggered recorder (intervention group, 280 patients) or a conventional 24-hour monitor (control group, 277 patients).
The researchers detected atrial fibrillation lasting ≥30 seconds in 16.1% of the intervention group and in 3.2% of the control group (P<0.001; number needed to screen, eight). A total of 9.9% of the intervention group and 2.5% of the control group had atrial fibrillation lasting ≥2.5 minutes (P<0.001). Oral anticoagulant therapy had been prescribed for more patients in the intervention vs. control group by 90 days (18.6 vs. 11.1 %; P=0.01).
"Noninvasive ambulatory ECG monitoring for a target of 30 days significantly improved the detection of atrial fibrillation by a factor of more than five and nearly doubled the rate of anticoagulant treatment, as compared with the standard practice of short-duration ECG monitoring," the authors write.
Several authors disclosed financial ties to the pharmaceutical industry.