Department of Cardiology, Lund University, Lund, Sweden; North-West Center for Diagnostics and Treatment of Arrythmias, St.Petersburg State University, St. Petersburg, Russia.
Acta Neurol Scand. 2014 Jun;129(6):412-9. doi: 10.1111/ane.12203. Epub 2013 Dec 2.
We assessed the prevalence of atrial fibrillation (AF) prior to first-ever ischemic stroke by examining a comprehensive electronic ECG archive.
The study sample comprised 336 consecutive stroke patients (median age 76 (IQ16) y, 200 men) enrolled in Lund Stroke Register from March 2001 to February 2002 and 336 age- and gender-matched controls without stroke history. AF prior to admission was studied using the regional electronic ECG database and record linkage with the National Swedish Hospital Discharge Register (SHDR). Medical records were reviewed for AF documentation and CHA2 DS2-VASc risk score.
Atrial fibrillation before or at stroke onset was detected in 109 (32.4%) stroke patients and 44 (13.1%) controls, P<0.001. Twenty-five of 109 stroke patients had AF detected only on previous ECG (n=14) or through the SHDR (n=11). The most prevalent type of AF in stroke group was non-permanent AF (59.6%). AF prevalence among patients admitted with sinus rhythm at hospital admission (n=266) was higher in those with CHA2 DS2 -VASc score≥6 (28.6%) than with CHA2 DS2-VASc score<6 (13.0%), P=0.043.
Comprehensive approach for AF screening allows detecting AF in one-third of patients admitted with first-ever ischemic stroke. Patients with high cardiovascular risk are more likely to have non-permanent AF.
通过检查全面的电子心电图档案，评估首次缺血性卒中前心房颤动（AF）的患病率。
研究样本包括 2001 年 3 月至 2002 年 2 月期间 Lund 卒中登记处纳入的 336 例连续卒中患者（中位年龄 76（IQ16）岁，200 例男性）和 336 例年龄和性别匹配的无卒中史对照组。使用区域电子心电图数据库和与全国瑞典医院出院登记处（SHDR）的记录链接来研究入院前的 AF。审查病历以获取 AF 记录和 CHA2 DS2-VASc 风险评分。
109 例（32.4%）卒中患者和 44 例（13.1%）对照组在卒中前或卒中发作时发现 AF，P<0.001。109 例卒中患者中有 25 例仅在前次心电图（n=14）或通过 SHDR（n=11）检测到 AF。卒中组中最常见的 AF 类型是非永久性 AF（59.6%）。入院时窦性心律的患者（n=266）中，CHA2 DS2-VASc 评分≥6 的患者（28.6%）比 CHA2 DS2-VASc 评分<6 的患者（13.0%）更易发生 AF，P=0.043。
全面的 AF 筛查方法可在三分之一的首次缺血性卒中患者中检测到 AF。心血管风险较高的患者更可能患有非永久性 AF。
