Atrial Tachycardia in Patients with Cryptogenic Stroke: Is there a Need For Anticoagulation?

Brief episodes of atrial tachycardia are a common finding in the Holter monitor recordings of elderly patients. Episodes of atrial tachycardia may convert to atrial fibrillation. Current guidelines do not recommend anti-coagulant therapy in patients with atrial tachycardia and risk factors for embolism.

To assess the incidence of atrial tachycardia in a 24 hour Holter monitor recording of patients admitted to hospital with ischemic stroke.

The patient cohort included two groups: 134 patients admitted with a diagnosis of ischemic stroke (the study group), and 68 consecutive patients with a diagnosis of syncope (the control group). Both groups used a Holter monitor.

There was no difference in the incidence of atrial tachycardia runs between the groups. Patients who suffered a stroke were more likely to be hypertensive (P < 0.05) and more likely to have a CHA2DS2-VASc score of ≥ 3 (P = 0.05).

Atrial tachycardia as recorded on a Holter monitor was not more prevalent in patients presenting with ischemic stroke. The occurrence of atrial tachycardia is not an indication for systemic anticoagulation.