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

Therese Fuchs, Amram Torjman

    The Israel Medical Association Journal : IMAJ
    |January 14, 2016
    PubMed

    Insights

    Atrial tachycardia on Holter monitor recordings was not more common in patients with ischemic stroke compared to syncope patients. This finding suggests atrial tachycardia alone does not warrant anticoagulation therapy.

    Area of Science:

    • Cardiology
    • Neurology
    • Geriatrics

    Background:

    • Atrial tachycardia episodes are common in elderly patients on Holter monitoring.
    • These episodes can progress to atrial fibrillation.
    • Current guidelines do not mandate anticoagulation for atrial tachycardia with embolism risk factors.

    Purpose of the Study:

    • To determine the incidence of atrial tachycardia in 24-hour Holter recordings of hospitalized ischemic stroke patients.
    • To compare this incidence with a control group diagnosed with syncope.

    Main Methods:

    • A cohort of 134 ischemic stroke patients (study group) and 68 syncope patients (control group) were analyzed.
    • Both groups underwent 24-hour Holter monitoring.

    Main Results:

    • No significant difference in the incidence of atrial tachycardia runs was observed between the ischemic stroke and syncope groups.
    • Ischemic stroke patients exhibited higher rates of hypertension (P < 0.05) and CHA2DS2-VASc scores of ≥ 3 (P = 0.05).

    Conclusions:

    • Atrial tachycardia detected by Holter monitoring is not more prevalent in patients presenting with ischemic stroke.
    • The presence of atrial tachycardia, as recorded by Holter, does not automatically indicate a need for systemic anticoagulation.
    Abstract

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