Department of Neuroscience, Kaiser Permanente, Redwood City, Redwood City, CA 94063, USA.
Stroke. 2012 Oct;43(10):2788-90. doi: 10.1161/STROKEAHA.112.665844. Epub 2012 Aug 7.
Patients with cryptogenic ischemic stroke may have undetected paroxysmal atrial fibrillation (PAF). We established the Stroke and Monitoring for PAF in Real Time (SMART) Registry to determine the yield of 30-day outpatient PAF monitoring in cryptogenic ischemic stroke.
The SMART Registry was a 3-year, prospective multicenter registry of 239 patients with cryptogenic ischemic stroke undergoing 30-day outpatient autotriggered PAF detection in Kaiser Permanente Northern California.
In intention-to-monitor analysis, PAF was detected in 29 of 239 patients (12.1%; 95% CI, 8.6%-16.9%). After retrospective chart review was performed, a new diagnosis of PAF was confirmed in 26 of 236 patients (11.0%; 95% CI, 7.6%-15.7%). The majority of detected PAF events were asymptomatic; only 6 of 98 recorded PAF events (6.1%) were patient-triggered or associated with symptoms.
-Approximately 1 in every 9 patients with cryptogenic ischemic stroke was found to have new PAF within 30 days. Routine monitoring in this population should be strongly considered.
隐源性缺血性卒中患者可能存在未被发现的阵发性心房颤动（PAF）。我们建立了Stroke and Monitoring for PAF in Real Time（SMART）登记研究，旨在确定在隐源性缺血性卒中患者中进行 30 天门诊 PAF 监测的检出率。
SMART 登记研究是一项为期 3 年的前瞻性多中心登记研究，纳入了 239 例在 Kaiser Permanente Northern California 接受 30 天门诊自动触发 PAF 检测的隐源性缺血性卒中患者。
在意向监测分析中，239 例患者中有 29 例（12.1%；95%CI，8.6%-16.9%）检测到 PAF。在进行回顾性病历审查后，236 例患者中有 26 例（11.0%；95%CI，7.6%-15.7%）被确诊为新的 PAF。大多数检测到的 PAF 事件为无症状；在 98 次记录的 PAF 事件中，仅有 6 次（6.1%）为患者触发或与症状相关。
大约每 9 例隐源性缺血性卒中患者中就有 1 例在 30 天内被发现有新发 PAF。在该人群中应强烈考虑常规监测。
