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Acta Neurol Belg. 2004 Mar;104(1):27-31.

Diagnostic and therapeutic impact of ambulatory electrocardiography in acute stroke.

Author information

1
Department of Neurology, UZ Gasthuisberg, Katholieke Universiteit Leuven, Belgium.

Abstract

Detection of paroxysmal atrial fibrillation (PAF) in patients with recent ischemic stroke or TIA suggests a cardioembolic etiology and leads to initiation of oral anticoagulation in suitable candidates. We assessed the diagnostic and therapeutic impact of adding ambulatory electrocardiography (24 hr ECG) to a standardised ischemic stroke workup.

METHODS:

We measured the frequency of detection of PAF in consecutive stroke patients who underwent 24 hr ECG that was not diagnosed clinically or on a standard 12-lead ECG.

RESULTS:

One hundred forty five ischemic stroke patients were included. 24 hr ECG was obtained in 136 patients (93.8%). Clinically unsuspected PAF was detected on 24 hr ECG in 7 patients (5.1%). The secondary prevention measure changed from antiplatelet agents to oral anticoagulation in 6 of 7 patients.

CONCLUSION:

Our findings suggest that ambulatory electrocardiography is a valuable diagnostic tool in the workup of stroke patients. Further prospective studies are needed to identify, subtypes of patients in whom the yield of ambulatory electrocardiography is higher.

PMID:
15143959
[Indexed for MEDLINE]

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