Piot Olivier, Guidoux Céline
Department of Cardiac Arrhythmia, Centre Cardiologique du Nord, Saint-Denis, France.
Department of Neurology and Stroke Unit, Bichat Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France.
Front Cardiovasc Med. 2023 Jul 27;10:1212128. doi: 10.3389/fcvm.2023.1212128. eCollection 2023.
The detection of atrial fibrillation (AF) in patients with cryptogenic stroke (CS) is an essential part of management to limit the risk of recurrence. However, in practice, not all patients who need AF screening are screened, or are screened with significant delays. The disparities of access to examinations, their costs as well as the increasing workload require an evolution of practices both in terms of organization and the type of equipment used. The ubiquity and ease of use of digital devices, together with their evaluation in large population and their expected lower cost, make them attractive as potential alternatives to current equipment at all stages of patient management. However, reliability and accuracy of each digital device for the detection of paroxysmal AF in CS patients should be established before consideration for inclusion in clinical practice. The aim of this short analysis is therefore to review the current practical issues for AF detection in post stroke patients, the potential benefits and issues using digital devices in stroke patients and to position the different digital devices as alternative to standard equipment at each stage of stroke patient pathway. This may help to design future studies for the evaluation of these devices in this context. Under this condition, the time for digital devices to detect AF after stroke seems very close.
在不明原因卒中（CS）患者中检测心房颤动（AF）是降低复发风险管理的重要组成部分。然而，在实际操作中，并非所有需要进行AF筛查的患者都接受了筛查，或者筛查存在显著延迟。检查机会的差异、检查费用以及工作量的增加，都要求在组织和使用的设备类型方面改进实践。数字设备的普及性和易用性，以及在大量人群中的评估和预期的较低成本，使其在患者管理的各个阶段成为当前设备有吸引力的潜在替代品。然而，在考虑将每种数字设备纳入临床实践之前，应先确定其检测CS患者阵发性AF的可靠性和准确性。因此，本简短分析的目的是回顾目前卒中后患者AF检测的实际问题、在卒中患者中使用数字设备的潜在益处和问题，并将不同的数字设备定位为卒中患者诊疗路径各阶段标准设备的替代品。这可能有助于设计未来在此背景下评估这些设备的研究。在这种情况下，卒中后数字设备检测AF的时间似乎非常接近。
