A New Diagnosis of Nonvalvular Atrial Fibrillation in Ischemic Stroke Patients Admitted to Stroke Unit: a Conceptual Replication Study
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Abstract
Ischemic stroke constitutes a significant morbidity and mortality source, with atrial fibrillation (AF) identified as a leading contributory factor. Particularly, nonvalvular AF presents diagnostic challenges due to its intermittent and often asymptomatic nature. Understanding the prevalence and detection patterns of AF associated with stroke is paramount for efficacious therapeutic interventions. In an observational study conducted at the Neurological Institute of Thailand's stroke unit, 549 acute ischemic stroke patients underwent ECG monitoring. The data revealed a 15.5% incidence of AF, bifurcated into 8.0% previously diagnosed and 7.5% newly diagnosed cases. Of the latter, 41.7% were detected through continuous ECG monitoring, with a detection time spanning from 18 minutes to 17 days during admission, emphasizing a median detection interval of approximately 2.29 days. Given the findings, we advocate for an extended continuous ECG monitoring duration of 2-3 days in specialized stroke units, aligning with previous research and augmenting precision in secondary stroke prevention modalities.
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