Barthélémy Jean-Claude, Féasson-Gérard Séverine, Garnier Pierre, Gaspoz Jean-Michel, Da Costa Antoine, Michel Daniel, Roche Frédéric
Service d'Exploration Fonctionnelle CardioRespiratoire, Laboratoire de Physiologie, CHU Nord, France.
Ann Noninvasive Electrocardiol. 2003 Jul;8(3):194-9. doi: 10.1046/j.1542-474x.2003.08305.x.
The etiology of stroke or transitory ischemic attack (TIA) remains frequently unknown. While paroxysmal atrial fibrillation (PAF) is often suspected, its presence remains difficult to establish. Therefore, we investigated the occurrence of PAF episodes in such a population using a long-term automatic cardiac event recorder.
We prospectively investigated 60 consecutive subjects admitted in our university hospital for stroke (n=44) or TIA (n=16), adding long-term automatic cardiac event recorders, with a target duration of 4 days, to standard investigations, which included 12-lead ECGs and 24-hour Holter recordings.
In 28 patients no etiology was found for their stroke or TIA. However, one or more than one PAF episode was found in 4 of them (14.3%) using the long-term automatic event recorder. In the 32 remaining patients, 8 presented with PAF, and this was considered as the cause of their stroke. In both groups, AF was paroxysmal. The PAF episodes' duration went from 1 to 96 hours (mean +/- standard deviation, 18 hours and 30 minutes+/-30 hours).
Patients suffering PAF episodes after ischemic stroke or TIA were statistically less often recognized using the 24-hour Holter ECG recording alone than the R-Test Evolution alone.
中风或短暂性脑缺血发作（TIA）的病因常常不明。虽然阵发性心房颤动（PAF）常被怀疑，但难以确定其是否存在。因此，我们使用长期自动心脏事件记录仪调查了该人群中PAF发作的情况。
我们前瞻性地调查了连续60名因中风（n = 44）或TIA（n = 16）入住我校医院的患者，在包括12导联心电图和24小时动态心电图记录的标准检查基础上，增加了目标持续时间为4天的长期自动心脏事件记录仪。
28例患者的中风或TIA未发现病因。然而，使用长期自动事件记录仪在其中4例（14.3%）患者中发现了一次或多次PAF发作。在其余32例患者中，8例出现PAF，这被认为是他们中风的原因。两组中，房颤均为阵发性。PAF发作持续时间为1至96小时（平均±标准差，18小时30分钟±30小时）。
与单独使用24小时动态心电图记录相比，单独使用R-Test Evolution能使缺血性中风或TIA后出现PAF发作的患者在统计学上得到更频繁的识别。
