Unit:
Κατεύθυνση Επεμβατική ΚαρδιολογίαLibrary of the School of Health Sciences
Supervisors info:
Γκατζούλης Κωνσταντίνος, Αναπληρωτής Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ, Επιβλέπων
Κυρίτση Ελένη, Ομότιμη Καθηγήτρια, Τμήμα Νοσηλευτικής, ΠΑ.Δ.Α.
Τούσουλης Δημήτριος, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Original Title:
Η επίπτωση των κολπικών έκτακτων συστολών σε ασθενείς με κρυπτογενές αγγειακό εγκεφαλικό επεισόδιο και η εμφάνιση κολπικής μαρμαρυγής κατά τη διάρκεια παρακολούθησης
Translated title:
The prognostic significance of excessive supraventricular ectopic activity for development of atrial fibrillation in patients with cryptogenic stroke
Summary:
Objective: Atrial fibrillation (AF) is a leading preventable cause of ischemic stroke. The aim of this study was the prognostic role of Excessive supraventricular ectopic activity (ESVEA) in the subsequent presence of atrial fibrillation in patients with cryptogenic stroke.
Design and method: We retrospectively evaluated 124 patients who were hospitalized during 2014 and 2015 with cryptogenic stroke. The premature atrial complexes/ hour (PACs/h) and the longest supraventricular run (<30sec) (longest SVR) have been recorded, from the 24-Hour Holter monitoring during their hospitalization. As primary outcome has been defined the presence of subsequent AF.
Results: One hundred and twenty-four patients were studied during a mean 5 years follow-up. The median age was 56 (IQR = 49 – 61.75) years and 35 (28,8%) were women. The mean age of AF group was 60 years vs. 54 years in non-AF group (p=0,01). There was no difference between the remaining variables (smoking, diabetes mellitus, dyslipidemia and hypertension) of the two groups (p>0.05). The median value of CHA2DS2-VASc score was 3 (IQR = 3 – 4) and was similar in the two groups (p=0.252). The AF group had significant more number of PACs/h, than the non-AF group (23.96/ h vs. 0.21/ h, p<0.001). No episodes of SVR was recorded in 76,6% of all patients and in all non-AF group patients. In contrast, the AF group had significantly longer “longest SVR” (3 sec. IQR=0.75 – 5, p<0.001). The association between PACs/h and “longest SVR” (p<0.001) has been showed.
Different multiple logistic regression models demonstrated the strong independent correlation between AF and the variables “PACs/h” and “longest SVR” (p≤0.001). ROC curve demonstrated the significant diagnostic value of “PACs/h” and “longest SVR” variates regarding AF .
Conclusions: The presence of ESVEA measured with 24h-Holter in patients with cryptogenic stroke, is associated with increased risk of AF.
Main subject category:
Health Sciences
Keywords:
Atrial fibrillation, Premature atrial complexes, Cryptogenic stroke, 24-Hour Holter
