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Higher Frequency of Premature Atrial Contractions Correlates With Atrial Fibrillation Detection after Cryptogenic Stroke.
Shimada, Yuki; Todo, Kenichi; Doijiri, Ryosuke; Yamazaki, Hidekazu; Sonoda, Kazutaka; Koge, Junpei; Iwata, Tomonori; Ueno, Yuji; Yamagami, Hiroshi; Kimura, Naoto; Morimoto, Masafumi; Kondo, Daisuke; Koga, Masatoshi; Nagata, Eiichiro; Miyamoto, Nobukazu; Kimura, Yoko; Gon, Yasufumi; Okazaki, Shuhei; Sasaki, Tsutomu; Mochizuki, Hideki.
Afiliación
  • Shimada Y; Department of Neurology, Osaka University Graduate School of Medicine, Japan (Y.S., K.T., Y.G., S.O., T.S., H.M.).
  • Todo K; Department of Neurology, Osaka University Graduate School of Medicine, Japan (Y.S., K.T., Y.G., S.O., T.S., H.M.).
  • Doijiri R; Department of Neurology (R.D.), Iwate Prefectural Central Hospital, Japan.
  • Yamazaki H; Department of Neurology (H.Y.), Yokohama Shintoshi Neurosurgical Hospital, Kanagawa, Japan.
  • Sonoda K; Department of Neurology, Saiseikai Fukuoka General Hospital, Japan (K.S., D.K.).
  • Koge J; Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan (J.K., M.K.).
  • Iwata T; Department of Neurology, Tokai University School of Medicine, Kanagawa, Japan (T.I., E.N.).
  • Ueno Y; Department of Neurology Juntendo University Faculty of Medicine, Tokyo, Japan (Y.U., N.M.).
  • Yamagami H; Department of Stroke Neurology, National Hospital Organization Osaka National Hospital, Japan (H.Y., Y.K.).
  • Kimura N; Department of Neurosurgery (N.K.), Iwate Prefectural Central Hospital, Japan.
  • Morimoto M; Department of Neurosurgery (M.M.), Yokohama Shintoshi Neurosurgical Hospital, Kanagawa, Japan.
  • Kondo D; Department of Neurology, Saiseikai Fukuoka General Hospital, Japan (K.S., D.K.).
  • Koga M; Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan (J.K., M.K.).
  • Nagata E; Department of Neurology, Tokai University School of Medicine, Kanagawa, Japan (T.I., E.N.).
  • Miyamoto N; Department of Neurology Juntendo University Faculty of Medicine, Tokyo, Japan (Y.U., N.M.).
  • Kimura Y; Department of Stroke Neurology, National Hospital Organization Osaka National Hospital, Japan (H.Y., Y.K.).
  • Gon Y; Department of Neurology, Osaka University Graduate School of Medicine, Japan (Y.S., K.T., Y.G., S.O., T.S., H.M.).
  • Okazaki S; Department of Neurology, Osaka University Graduate School of Medicine, Japan (Y.S., K.T., Y.G., S.O., T.S., H.M.).
  • Sasaki T; Department of Neurology, Osaka University Graduate School of Medicine, Japan (Y.S., K.T., Y.G., S.O., T.S., H.M.).
  • Mochizuki H; Department of Neurology, Osaka University Graduate School of Medicine, Japan (Y.S., K.T., Y.G., S.O., T.S., H.M.).
Stroke ; 55(4): 946-953, 2024 Apr.
Article en En | MEDLINE | ID: mdl-38436115
ABSTRACT

BACKGROUND:

Covert atrial fibrillation (AF) is a major cause of cryptogenic stroke. This study investigated whether a dose-dependent relationship exists between the frequency of premature atrial contractions (PACs) and AF detection in patients with cryptogenic stroke using an insertable cardiac monitor (ICM).

METHODS:

We enrolled consecutive patients with cryptogenic stroke who underwent ICM implantation between October 2016 and September 2020 at 8 stroke centers in Japan. Patients were divided into 3 groups according to the PAC count on 24-hour Holter ECG ≤200 (group L), >200 to ≤500 (group M), and >500 (group H). We defined a high AF burden as above the median of the cumulative duration of AF episodes during the entire monitoring period. We evaluated the association of the frequency of PACs with AF detection using log-rank trend test and Cox proportional hazard model and with high AF burden using logistic regression model, adjusting for age, sex, CHADS2 score.

RESULTS:

Of 417 patients, we analyzed 381 patients with Holter ECG and ICM data. The median age was 70 (interquartile range, 59.5-76.5), 246 patients (65%) were males, and the median duration of ICM recording was 605 days (interquartile range, 397-827 days). The rate of new AF detected by ICM was higher in groups with more frequent PAC (15.5%/y in group L [n=277] versus 44.0%/y in group M [n=42] versus 71.4%/y in group H [n=62]; log-rank trend P<0.01). Compared with group L, the adjusted hazard ratios for AF detection in groups M and H were 2.11 (95% CI, 1.24-3.58) and 3.23 (95% CI, 2.07-5.04), respectively, and the adjusted odds ratio for high AF burden in groups M and H were 2.57 (95% CI, 1.14-5.74) and 4.25 (2.14-8.47), respectively.

CONCLUSIONS:

The frequency of PACs was dose-dependently associated with AF detection in patients with cryptogenic stroke.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Fibrilación Atrial / Complejos Atriales Prematuros / Accidente Cerebrovascular / Accidente Cerebrovascular Isquémico Límite: Aged / Female / Humans / Male Idioma: En Revista: Stroke Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Fibrilación Atrial / Complejos Atriales Prematuros / Accidente Cerebrovascular / Accidente Cerebrovascular Isquémico Límite: Aged / Female / Humans / Male Idioma: En Revista: Stroke Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos