The aim of this study is to determine the diagnostic yield of continuous 7-day Holter ECG for detecting covert paroxysmal atrial fibrillation in patients with recent embolic stroke or transient ischemic attack (TIA) of undetermined cause after completion of a standard clinical work up including an initial 24-hour Holter monitoring.
Covert atrial fibrillation (AF) is a relevant potential cause of a recently proposed clinical construct, "Embolic Stroke of Undetermined Source (ESUS)". However, routine post-stroke work up including 24-hour Holter monitoring may fail to detect paroxysmal AF. A recent systematic review has shown an increased AF detection rate with longer monitoring durations. The aim of this study is to evaluate the effectiveness of a novel ambulatory 7-day Holter ECG (EV-201, Parama-Tech inc.) for detecting AF in patients with recent ESUS after completion of a standard clinical examination.
- Observation: Case-Only
- Perspective: Prospective
- Sampling: Probability Sample
Patients with recent embolic stroke of undetermined source
|Type||Measure||Time Frame||Safety Issue|
|Primary||Detection of any atrial fibrillation||After examination of 7-day Holter monitoring (within 90 days of stroke onset)||No|
|Secondary||Change of antithrombotic drugs||After the examination of 7-day Holter monitoring||No|
|Secondary||Any ischemic or hemorrhagic event||365 days after index stroke||Yes|
|Secondary||Any adverse event related to 7-day Holter monitoring||After the examination of 7-day Holter monitoring||Yes|
|Secondary||Time to detection of atrial fibrillation on 7-day Holter monitoring||After the examination of 7-day Holter monitoring||No|
|Secondary||Atrial fibrillation burden||After the examination of 7-day Holter monitoring||No|