Sejr Michala Herskind, Nielsen Jens Cosedis, Damgaard Dorte, Sandal Birgitte Forsom, May Ole
Cardiovascular Research Unit, Department of Medicine, Regional Hospital West Jutland, Gl. Landevej 61, Herning, Denmark.
Department of Cardiology, Aarhus University Hospital.
J Electrocardiol. 2017 May-Jun;50(3):287-293. doi: 10.1016/j.jelectrocard.2017.01.009. Epub 2017 Jan 17.
Atrial fibrillation (AF) is the most common cardiac cause of ischemic stroke and transient ischemic attack (IS/TIA).
To compare the diagnostic value of seven-day external loop recording (ELR) and two-day Holter recording for detecting AF after IS/TIA.
191 IS/TIA patients without AF history. Endpoint was AF >30s. We started two-day Holter recording and seven-day ELR simultaneously.
Seven-day ELR and two-day Holter recording detected the same three AF patients. ELR detected another six patients with AF adjudicated by cardiologists, four detections after Holter (3 vs. 7, p=0.125) and two false-positive detections during Holter. Seven-day ELR automatically classified 50/191 patients (26%) with AF, but only 7/50 (14%) were confirmed as AF by cardiologists.
Seven-day ELR did not detect significantly more patients with AF than two-day Holter recording. 86% of patients with ELR-classified AF were false positives, indicating a poor performance of the automatic AF detection algorithm used.
心房颤动（AF）是缺血性卒中及短暂性脑缺血发作（IS/TIA）最常见的心脏病因。
比较7天体外循环记录仪（ELR）和24小时动态心电图监测对IS/TIA后房颤检测的诊断价值。
191例无房颤病史的IS/TIA患者。观察终点为房颤持续时间>30秒。我们同时启动了24小时动态心电图监测和7天ELR监测。
7天ELR和24小时动态心电图监测发现了相同的3例房颤患者。ELR又检测出另外6例经心脏病专家判定为房颤的患者，其中4例在动态心电图监测后检测到（3例与7例，p=0.125），2例在动态心电图监测期间出现假阳性检测。7天ELR自动将191例患者中的50例（26%）分类为房颤，但心脏病专家仅确认其中7例（14%）为房颤。
7天ELR检测到的房颤患者数量并不显著多于24小时动态心电图监测。ELR分类为房颤的患者中86%为假阳性，表明所使用的房颤自动检测算法性能不佳。
