Hoppe U C
Klinik III für Innere Medizin, Universität zu Köln, Köln, Deutschland.
Nervenarzt. 2011 Feb;82(2):166, 168-71. doi: 10.1007/s00115-010-3112-7.
Approximately every fourth stroke results from cardiac embolism. Atrial fibrillation has been recognized as a common cause for thromboembolic stroke. Detection of unknown atrial fibrillation is an important clinical challenge, as anticoagulation may effectively reduce the risk of recurrent ischemic stroke. In all patients with a cryptogenic stroke 24-h Holter monitoring should be performed in addition to a standard ECG to detect paroxysmal atrial fibrillation. In addition, it is useful to pay attention to atrial fibrillation during continuous bedside ECG monitoring on the stroke unit and in pacemaker interrogation. The indication for longer ECG monitoring by implantable loop recorders may be considered individually based on the expected probability of atrial fibrillation. The potential benefit of these devices is currently being evaluated in clinical trials.
大约每四例中风是由心脏栓塞引起的。心房颤动已被公认为血栓栓塞性中风的常见原因。检测未知的心房颤动是一项重要的临床挑战,因为抗凝治疗可有效降低复发性缺血性中风的风险。对于所有不明原因的中风患者,除了进行标准心电图检查外,还应进行24小时动态心电图监测以检测阵发性心房颤动。此外,在中风病房进行床边连续心电图监测以及起搏器问询时留意心房颤动很有帮助。可根据心房颤动的预期概率单独考虑是否有必要使用植入式循环记录仪进行更长时间的心电图监测。目前正在临床试验中评估这些设备的潜在益处。