Supraventricular Premature Beats and Short Atrial Runs Predict Atrial Fibrillation in Continuously Monitored Patients With Cryptogenic Stroke

被引:73
作者
Kochhaeuser, Simon [1 ]
Dechering, Dirk G. [1 ]
Dittrich, Ralf [2 ]
Reinke, Florian [1 ]
Ritter, Martin A. [2 ]
Ramtin, Shahram [1 ]
Duning, Thomas [2 ]
Frommeyer, Gerrit [1 ]
Eckardt, Lars [1 ]
机构
[1] Univ Munster, Div Electrophysiol, Dept Cardiovasc Med, D-48149 Munster, Germany
[2] Univ Munster, Dept Neurol, D-48149 Munster, Germany
关键词
atrial fibrillation; atrial premature complexes; stroke; TRIAL;
D O I
10.1161/STROKEAHA.113.003788
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Background and Purpose Supraventricular premature beats (SPBs) may help to assess the risk of atrial fibrillation (AF) in patients with cryptogenic stroke and therefore guide therapy. Methods An internal loop recorder was implanted in consecutive patients with acute cryptogenic stroke. The occurrence and quantity of SPBs and short supraventricular runs (SVRs) in 24-hour ECG in patients with and without future AF were analyzed. We evaluated the relative risk of the upper quartile of SPB and SVR patients against the remainder and used binary logistic regression to evaluate a possible independent influence of SPBs and SVRs on AF occurrence. Results Twelve of 70 included patients (mean age, 5913 years) experienced development of AF during a mean monitoring duration of 536 +/- 212 days. Patients with AF had a median of 22.8 SPBs/h versus 1.2 SPBs/h (P<0.0001) in patients without AF and a median of 0.7 SVRs/h (AF) versus 0 SVR/h (non-AF). Patients in the upper quartile of SPBs (>14.1/h) and SVRs (>0.2/h) demonstrated a relative risk of 4.0 (95% confidence interval, 1.1-14.6; P=0.04) and 6.9 (95% confidence interval, 1.8-26.7; P=0.005) for future AF, respectively. In binary logistic regression, SPBs (P=0.02) and SVRs (P=0.05) remained significant independent predictors for occurrence of AF. Conclusions Numerous SPBs and SVRs demonstrated a high risk for future AF in patients with cryptogenic stroke.
引用
收藏
页码:884 / 886
页数:3
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