慢性非心源性栓塞性缺血性卒中患者使用可穿戴式心电图设备检测心律失常及其预测因素
Detection and Predictors of Arrhythmia in Patients with Chronic Noncardioembolic Ischemic Stroke on Wearable Electrocardiogram Device.
作者信息
Akimoto Yu, Ito Yoshiro, Tsurushima Hideo, Hosoo Hisayuki, Marushima Aiki, Hayakawa Mikito, Nakamura Kazuhiro, Fujita Keishi, Terakado Toshitsugu, Yamagami Hiroshi, Matsumaru Yuji, Ishikawa Eiichi
机构信息
Department of Neurosurgery, Institute of Medicine, University of Tsukuba, Ibaraki, Japan.
R&D Center for Frontiers of MIRAI in Policy and Technology, University of Tsukuba, Ibaraki, Japan.
出版信息
Asian J Neurosurg. 2025 May 5;20(3):549-555. doi: 10.1055/s-0045-1809050. eCollection 2025 Sep.
OBJECTIVES
The screening examination for arrhythmias in patients with chronic noncardioembolic ischemic stroke is limited. This study aimed to investigate the prevalence of arrhythmia in patients with chronic noncardioembolic ischemic stroke using a stick-on wearable device.
MATERIALS AND METHODS
This was a prospective observational study conducted between July 2020 and February 2022 involving 176 patients with a history of noncardioembolic ischemic stroke. Patients receiving anticoagulant therapy were excluded. For the evaluation of arrhythmias, the patients wore a stick-on wearable device for a maximum of approximately 7 days. We investigated the prevalence of arrhythmia and its associated factors.
RESULTS
The mean measurement time was 121.3 ± 45.3 hours. Atrial fibrillation was present in 2 (1.1%) patients, frequent premature atrial contractions (PACs) in 69 (39.2%), and frequent premature ventricular contractions (PVCs) in 36 (20.5%). Regression analysis showed that the risk factors independently associated with frequent PACs were age (odds ratio [OR] 1.103, 95% confidence interval [CI] 1.055-1.153; < 0.001) and cilostazol use (OR 2.681, 95% CI 1.338-5.371; = 0.005). Regression analysis showed that the risk factors independently associated with frequent PVCs were age (OR 1.047, 95% CI 1.002-1.095; = 0.043), male sex (OR 3.834, 95% CI 1.441-11.045; = 0.013), and cilostazol use (OR 2.968, 95% CI 1.363-6.463; = 0.006).
CONCLUSION
The prevalence of frequent PVCs is higher in patients with chronic noncardioembolic ischemic stroke than in the general population. The stick-on wearable device is a useful screening tool for arrhythmia in patients with chronic noncardioembolic ischemic stroke.
目的
慢性非心源性栓塞性缺血性卒中患者心律失常的筛查检查有限。本研究旨在使用粘贴式可穿戴设备调查慢性非心源性栓塞性缺血性卒中患者心律失常的患病率。
材料与方法
这是一项前瞻性观察性研究，于2020年7月至2022年2月进行，纳入176例有非心源性栓塞性缺血性卒中病史的患者。排除接受抗凝治疗的患者。为评估心律失常，患者佩戴粘贴式可穿戴设备最长约7天。我们调查了心律失常的患病率及其相关因素。
结果
平均测量时间为121.3±45.3小时。2例（1.1%）患者存在心房颤动，69例（39.2%）患者存在频发房性早搏（PAC），36例（20.5%）患者存在频发室性早搏（PVC）。回归分析显示，与频发PAC独立相关的危险因素为年龄（比值比[OR]1.103，95%置信区间[CI]1.055 - 1.153；P<0.001）和使用西洛他唑（OR 2.681，95%CI 1.338 - 5.371；P = 0.005）。回归分析显示，与频发PVC独立相关的危险因素为年龄（OR 1.047，95%CI 1.002 - 1.095；P = 0.043）、男性（OR 3.834，95%CI 1.441 - 11.045；P = 0.013）和使用西洛他唑（OR 2.968，95%CI 1.363 - 6.463；P = 0.006）。
结论
慢性非心源性栓塞性缺血性卒中患者频发PVC的患病率高于一般人群。粘贴式可穿戴设备是慢性非心源性栓塞性缺血性卒中患者心律失常的一种有用筛查工具。
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