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Large variations in atrial fibrillation screening practice after ischemic stroke and transient ischemic attack in Sweden: a survey study.
Strååt, Kajsa; Isaksson, Eva; Laska, Ann Charlotte; Rooth, Elisabeth; Svennberg, Emma; Åsberg, Signild; Wester, Per; Engdahl, Johan.
Afiliación
  • Strååt K; Department of Clinical Sciences, Karolinska Institutet, Danderyd Hospital, Stockholm, Sweden. kajsa.straat@ki.se.
  • Isaksson E; Department of Cardiology, Danderyd Hospital, Stockholm, SE-182 88, Sweden. kajsa.straat@ki.se.
  • Laska AC; Department of Clinical Sciences, Karolinska Institutet, Danderyd Hospital, Stockholm, Sweden.
  • Rooth E; Department of Clinical Sciences, Karolinska Institutet, Danderyd Hospital, Stockholm, Sweden.
  • Svennberg E; Department of Clinical Sciences, Karolinska Institutet, Danderyd Hospital, Stockholm, Sweden.
  • Åsberg S; Department of Medicine, Karolinska Institutet, Karolinska University Hospital Huddinge, Stockholm, Sweden.
  • Wester P; Department of Medical Sciences, Uppsala University, Uppsala, Sweden.
  • Engdahl J; Department of Clinical Sciences, Karolinska Institutet, Danderyd Hospital, Stockholm, Sweden.
BMC Neurol ; 24(1): 120, 2024 Apr 11.
Article en En | MEDLINE | ID: mdl-38605308
ABSTRACT

BACKGROUND:

Atrial fibrillation (AF) screening after ischemic stroke or transient ischemic attack (TIA) is given high priority in clinical guidelines. However, patient selection, electrocardiogram (ECG) modality and screening duration remains undecided and current recommendations vary.

METHODS:

The aim of this study was to investigate the clinical practice of AF screening after ischemic stroke or TIA at Swedish stroke units. In collaboration with the stakeholders of the Swedish Stroke Register (Riksstroke) a digital survey was drafted, then tested and revised by three stroke consultants. The survey consisted of 17 multiple choice/ free text questions and was sent by e-mail to the medical directors at all stroke units in Sweden.

RESULTS:

All 72 stroke units in Sweden responded to the survey. Most stroke units reported that ≥ 75% of ischemic stroke (69/72 stroke units) or TIA patients (67/72 stroke units), without previously known AF, were screened for AF. Inpatient telemetry ECG was the method of first-choice in 81% of the units, but 7% reported lack of access. A variety of standard monitoring durations were used for inpatient telemetry ECG. The second most common choice was Holter ECG (17%), also with considerable variations in monitoring duration. Other AF screening modalities were used as a first-choice method (handheld and patch ECG) but less frequently.

CONCLUSIONS:

Clinical practice for AF screening after ischemic stroke or TIA differed between Swedish stroke units, both in choice of AF screening methods as well as in monitoring durations. There is an urgent need for evidence and evidence-based recommendations in this field. TRIAL REGISTRATION Not applicable.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Fibrilación Atrial / Ataque Isquémico Transitorio / Accidente Cerebrovascular / Accidente Cerebrovascular Isquémico Límite: Humans País/Región como asunto: Europa Idioma: En Revista: BMC Neurol Asunto de la revista: NEUROLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Suecia Pais de publicación: Reino Unido
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Fibrilación Atrial / Ataque Isquémico Transitorio / Accidente Cerebrovascular / Accidente Cerebrovascular Isquémico Límite: Humans País/Región como asunto: Europa Idioma: En Revista: BMC Neurol Asunto de la revista: NEUROLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Suecia Pais de publicación: Reino Unido