Saint Vincent Hospital.
Ther Clin Risk Manag. 2011 Jan 28;7:33-7. doi: 10.2147/TCRM.S15079.
Paroxysmal atrial fibrillation (PAF) is perhaps the most underdiagnosed mechanism of apparent cryptogenic stroke (CS). Various studies have shown that increasing the duration of monitoring can increase the diagnosis of PAF in CS.
We compared demographic and risk factors for ischemic stroke across different TOAST (Trial of ORG 10172 in Acute Stroke Treatment) stroke subtypes to look for clinical differences between other subtypes and CS and subsequently performed periodic Holter monitoring and imaging studies in apparent CS patients.
Of the 298 patients with ischemic stroke, 17% had CS. Periodic holter monitoring enabled diagnosis of PAF in 29% of patients. Five of 51 patients with CS had recurrent ischemic stroke and all 5 were demonstrated as PAF on repeated Holter monitoring.
Long-term periodic rhythm monitoring in patients with apparent CS showed PAF in a significant percentage of CS patients, which altered subsequent treatment.
阵发性心房颤动（PAF）可能是最易被漏诊的隐源性卒中（CS）发病机制。多项研究表明，延长监测时间可提高 CS 中 PAF 的诊断率。
我们比较了不同 TOAST（急性脑卒中治疗中 ORG 10172 的试验）脑卒中亚型的人口统计学和危险因素，以寻找其他亚型与 CS 之间的临床差异，随后对疑似 CS 患者进行定期动态心电图监测和影像学研究。
在 298 例缺血性脑卒中患者中，17%为 CS。定期动态心电图监测使 29%的患者诊断出 PAF。51 例 CS 患者中有 5 例出现复发性缺血性卒中，所有 5 例均通过重复动态心电图监测证实为 PAF。
对疑似 CS 患者进行长期定期节律监测显示，CS 患者中有相当比例的患者存在 PAF，这改变了后续的治疗。
