Τίτλος:
Duration of implantable cardiac monitoring and detection of atrial fibrillation in ischemic stroke patients: A systematic review and meta-analysis
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Background and Purpose Current guidelines do not provide firm directions on atrial fibrillation (AF) screening after ischemic stroke (IS). We sought to investigate the association of implantable cardiac monitoring (ICM) duration with the yield of AF detection in IS patients. Methods We included studies reporting AF detection rates by ICM in IS patients with negative initial AF screening. We excluded studies reporting prolonged cardiac monitoring with devices other than ICM, not providing AF detection rates or monitoring duration, and reporting overlapping data for the same population. The random-effects model was used for all pooled estimates and meta-regression analyses. Results We included 28 studies (4,531 patients, mean age 65 years). In meta-regression analyses, the proportion of AF detection by ICM was independently associated with monitoring duration (coefficient=0.015; 95% confidence interval [CI], 0.005 to 0.024) and mean patient age (coefficient=0.009; 95% CI, 0.003 to 0.015). No associations were detected with other patient characteristics, including IS subtype (cryptogenic vs. embolic stroke of undetermined source) or time from IS onset to CM implantation. In subgroup analyses, significant differences (P<0.001) in the AF detection rates were found for ICM duration (<6 months: 5% [95% CI, 3% to 6%]; ≥6 and ≤12 months: 21% [95% CI, 16% to 25%]; >12 and ≤24 months: 26% [95% CI, 22% to 31%]; >24 months: 34% [95% CI, 29% to 39%]). Conclusions Extended duration of ICM monitoring and increased patient age are factors that substantially increase AF detection in IS patients with initial negative AF screening. © 2019 Korean Stroke Society.
Συγγραφείς:
Tsivgoulis, G.
Katsanos, A.H.
Köhrmann, M.
Caso, V.
Perren, F.
Palaiodimou, L.
Deftereos, S.
Giannopoulos, S.
Ellul, J.
Krogias, C.
Mavridis, D.
Triantafyllou, S.
Alexandrov, A.W.
Schellinger, P.D.
Alexandrov, A.V.
Περιοδικό:
International Journal of Stroke
Εκδότης:
Korean Stroke Society
Λέξεις-κλειδιά:
Article; atrial fibrillation; brain ischemia; cardiac monitoring; cardiovascular parameters; cerebrovascular accident; CHA2DS2-VASc score; diabetes mellitus; human; hypertension; meta analysis; monitoring; screening; sensitivity analysis; systematic review; time threshold; treatment duration
DOI:
10.5853/jos.2019.01067
