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Low Incidence of Atrial Fibrillation in Patients with Transient Ischemic Attack
Kenneth Bruun Pedersen1, Alexander Chemnitz, Charlotte Madsen
1Department of Cardiology, Odense University Hospital, Odense, Denmark.
Insights
Detecting atrial fibrillation (AF) in transient ischemic attack (TIA) patients using electrocardiogram (ECG) and Holter monitoring revealed a low incidence of AF. Further prospective studies are recommended to confirm these findings regarding AF detection in TIA.
Area of Science:
- Cardiology
- Neurology
Background:
- Atrial fibrillation (AF) is a significant risk factor for stroke.
- Current guidelines recommend AF screening in ischemic stroke and transient ischemic attack (TIA) patients.
- The diagnostic yield of AF screening in TIA patients requires further investigation.
Purpose of the Study:
- To evaluate the diagnostic yield of 12-lead ECG and 72-hour Holter monitoring for detecting AF in TIA patients.
- To determine the incidence of newly diagnosed AF in patients presenting with TIA.
Main Methods:
- Retrospective analysis of TIA patients at Odense University Hospital (2014-2014).
- Patients underwent admission 12-lead ECG and 72-hour Holter monitoring.
- TIA diagnosis was based on the WHO definition.
Main Results:
- Out of 171 TIA patients without known AF, 4 (2.3%) were diagnosed with AF on admission ECG.
- An additional 2 patients (1.2%) were diagnosed with AF via Holter monitoring.
- A total of 6 patients (3.5%) were diagnosed with AF; these patients were significantly older.
Conclusions:
- The incidence of AF detected by ECG and 72-hour Holter monitoring in TIA patients is low.
- Older age was associated with a higher likelihood of AF diagnosis in TIA patients.
- Prospective studies are necessary to validate these findings and inform clinical guidelines.
Background:
Atrial fibrillation (AF) is a major cause of stroke. Therefore, all patients with ischemic stroke or transient ischemic attack (TIA) should be examined with 12-lead electrocardiogram (ECG) and continuous monitoring to detect AF. Current guidelines recommend at least 24 h continuous ECG monitoring, which is primarily based on studies investigating patients with ischemic stroke. The aim of our study was to investigate the diagnostic yield of 12-lead ECG and Holter monitoring in patients with TIA.
Methods:
We retrospectively investigated all patients diagnosed with TIA at Odense University Hospital, Denmark, from January 1, 2014 to December 31, 2014. TIA was a clinical diagnosis according to the WHO definition. Patients received admission ECG and 72-hour Holter monitoring after discharge.
Results:
171 patients without known AF were diagnosed with TIA. Four (2.3%) were diagnosed with AF on admission ECG. Another 2 (1.2%) were diagnosed with AF on Holter monitoring. In total, 6 patients (3.5%) were diagnosed with AF. Patients with AF were significantly older (mean age 79.4 [95% CI 65.1-93.6] years) than patients without AF (mean age 67.6 [95% CI 65.6-69.5] years) but otherwise showed no difference in baseline characteristics.
Conclusion:
In this retrospective study, patients with TIA had a low incidence of AF detected with ECG and 72-hour Holter monitoring. Prospective studies are needed to confirm these findings.
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