Günaydin Sefer, Baştan Birgül, Acar Hürtan, Balci Belgin Petek, Mutlu Aytül, Çokar Özlem
Clinic of Neurology, Haseki Training and Research Hospital, İstanbul, Turkey.
Noro Psikiyatr Ars. 2017 Dec;54(4):339-342. doi: 10.5152/npa.2016.17012. Epub 2016 Apr 26.
Paroxysmal atrial fibrillation (PAF) has a similar risk with persistent AF for ischemic stroke. Holter monitorization (HM) and other long-term monitorization methods increased the detection of PAF and short-lasting runs of tachyarrhythmias. Their classification as PAF and roles in the etiology of ischemic stroke is controversial. In this study, we aimed to investigate the frequency of any duration of PAF and clinical characteristics of the patients with acute ischemic stroke who have undergone 24-hrs HM.
Patients with acute ischemic stroke and transient ischemic attack (TIA) hospitalized in the Neurology ward and undergone 24-hrs of HM during their hospital stay were included in the study. HM reports, clinical, and laboratory characteristics were analyzed, retrospectively. Patients were grouped into three based on HM: 1st group, without PAF; 2nd group, PAF >30 seconds (s) and 3rd group, PAF<30s.
PAF of any duration was detected in 18.8% (n=49) of 261 patients. The duration of PAF was <30s in 16.1% (n=42) and >30s in 2.7% (n=7) of the patients. The mean age, left atrium diameter and CHA2DS2-VASc scores of the second group were significantly higher than the first group (p<0.001, p<0.001 and p=0.007; respectively). The mean age, left atrium diameter, modified Rankin Scores (mRS), and CHA2DS2-VASc scores of the third group were significantly higher than the first group (p<0.001; for all). There was no difference between the second and the third groups in means of mean age, left atrial diameter, MRS, and CHA2DS2-VASc scores (p<0.017, for all).
In this study, 24-hrs HM in the early period of acute ischemic stroke results yielded a high frequency of PAF<30s and predictive features were in parallel with the literature.
阵发性心房颤动（PAF）与持续性房颤导致缺血性卒中的风险相似。动态心电图监测（HM）及其他长期监测方法提高了PAF和短暂性快速心律失常发作的检出率。它们被归类为PAF及其在缺血性卒中病因学中的作用存在争议。在本研究中，我们旨在调查接受24小时HM的急性缺血性卒中患者中任何持续时间的PAF发生频率及临床特征。
纳入在神经内科病房住院、住院期间接受24小时HM的急性缺血性卒中和短暂性脑缺血发作（TIA）患者。回顾性分析HM报告、临床及实验室特征。根据HM将患者分为三组：第一组，无PAF；第二组，PAF>30秒（s）；第三组，PAF<30秒。
261例患者中，18.8%（n = 49）检测到任何持续时间的PAF。PAF持续时间<30秒的患者占16.1%（n = 42），>30秒的患者占2.7%（n = 7）。第二组患者的平均年龄、左心房直径和CHA2DS2-VASc评分显著高于第一组（分别为p<0.001、p<0.001和p = 0.007）。第三组患者的平均年龄、左心房直径、改良Rankin评分（mRS）和CHA2DS2-VASc评分显著高于第一组（均为p<0.001）。第二组和第三组在平均年龄、左心房直径、MRS和CHA2DS2-VASc评分方面无差异（均为p<0.017）。
在本研究中，急性缺血性卒中早期进行24小时HM，结果显示PAF<30秒的发生率较高，且预测特征与文献一致。
