Sezenöz Burak, Yalçın Yakup, Caglayan Hale B, Yazgan Elif, Kızıltunç Emrullah, Ünlü Serkan, Altıparmak Taylan, Nazlıel Bijen, Özdemir Hüseyin M
Department of Cardiology, Faculty of Medicine, Gazi University, Ankara, Turkey.
Department of Neurology, Faculty of Medicine, Gazi University, Ankara, Turkey.
Ann Indian Acad Neurol. 2023 Nov-Dec;26(6):902-907. doi: 10.4103/aian.aian_308_23. Epub 2023 Oct 13.
The clinical importance of supraventricular run (SVR) is uncertain in the management of patients with previous cerebrovascular events. We aim to evaluate the role of SVRs in the development of future atrial fibrillation (AF) in patients diagnosed with ischemic stroke.
We retrospectively evaluated patients who underwent 24-h Holter monitoring for the evaluation of possible AF after ischemic cerebrovascular events. The presence and duration of SVR were noted. Subsequent diagnosis of AF was searched in patients with sinus rhythm.
A total of 694 patients were included in the analysis. SVR was detected in 104 (14.9%) patients in the study group. Seventy-one (10.2%) patients were diagnosed with AF in the follow-up. SVRs were more prevalent among patients with AF ( < 0.001). The median atrial run duration was 5.96 (2.02-17.84) s in the AF absent group vs. 8.76 (3.78-17.62) s in the AF present group ( < 0.001). The best predictive cut-off duration of an atrial run was 8 s (sensitivity = 61.5% and specificity = 74.4%, Area Under Curve (AUC) = 0.708). Cox regression analysis showed that age (odds ratio [OR]: 1.03, 95% confidence interval [CI]: 1.00-1.060, = 0.020), presence of short supraventricular run (OR: 2.53, 95% CI 1.40-4.57, = 0.002), and left atrial diameter (OR: 1.13 95% CI: 1.07-1.19, < 0.001) were the independent predictors of AF development in the follow-up.
Age, left atrial diameter, and the presence of SVRs are associated with an increased risk of future AF after ischemic stroke. SVR duration may be an important parameter in risk stratification.
室上性心动过速（SVR）在既往有脑血管事件患者的管理中的临床重要性尚不确定。我们旨在评估SVR在缺血性中风患者未来发生心房颤动（AF）中的作用。
我们回顾性评估了因缺血性脑血管事件后可能发生AF而接受24小时动态心电图监测的患者。记录SVR的存在情况和持续时间。在窦性心律患者中搜索后续的AF诊断。
共有694例患者纳入分析。研究组中104例（14.9%）患者检测到SVR。随访中有71例（10.2%）患者被诊断为AF。SVR在AF患者中更为常见（<0.001）。无AF组的房性心动过速持续时间中位数为5.96（2.02 - 17.84）秒，而有AF组为8.76（3.78 - 17.62）秒（<0.001）。房性心动过速的最佳预测截断持续时间为8秒（敏感性 = 61.5%，特异性 = 74.4%，曲线下面积（AUC） = 0.708）。Cox回归分析显示，年龄（比值比[OR]：1.03，95%置信区间[CI]：1.00 - 1.060，P = 0.020）、短室上性心动过速的存在（OR：2.53，95% CI 1.40 - 4.57，P = 0.002）和左心房直径（OR：1.13，95% CI：1.07 - 1.19，P < 0.001）是随访中AF发生的独立预测因素。
年龄、左心房直径和SVR的存在与缺血性中风后未来发生AF的风险增加相关。SVR持续时间可能是风险分层中的一个重要参数。
