Higher Frequency of Premature Atrial Contractions Correlates with Atrial Fibrillation Detection after Cryptogenic Stroke

Yuki Shimada, Kenichi Todo, Ryosuke Doijiri, Hidekazu Yamazaki, Kazutaka Sonoda, Junpei Koge, Tomonori Iwata, Yuji Ueno, Hiroshi Yamagami, Naoto Kimura, Masafumi Morimoto, Daisuke Kondo, Masatoshi Koga, Eiichiro Nagata, Nobukazu Miyamoto, Yoko Kimura, Yasufumi Gon, Shuhei Okazaki, Tsutomu Sasaki, Hideki Mochizuki

研究成果: ジャーナルへの寄稿学術論文査読

1 被引用数 (Scopus)

抄録

BACKGROUND: Covert atrial fibrillation (AF) is a major cause of cryptogenic stroke. This study investigated whether a dose-dependent relationship exists between the frequency of premature atrial contractions (PACs) and AF detection in patients with cryptogenic stroke using an insertable cardiac monitor (ICM). METHODS: We enrolled consecutive patients with cryptogenic stroke who underwent ICM implantation between October 2016 and September 2020 at 8 stroke centers in Japan. Patients were divided into 3 groups according to the PAC count on 24-hour Holter ECG: ≤200 (group L), >200 to ≤500 (group M), and >500 (group H). We defined a high AF burden as above the median of the cumulative duration of AF episodes during the entire monitoring period. We evaluated the association of the frequency of PACs with AF detection using log-rank trend test and Cox proportional hazard model and with high AF burden using logistic regression model, adjusting for age, sex, CHADS2score. RESULTS: Of 417 patients, we analyzed 381 patients with Holter ECG and ICM data. The median age was 70 (interquartile range, 59.5-76.5), 246 patients (65%) were males, and the median duration of ICM recording was 605 days (interquartile range, 397-827 days). The rate of new AF detected by ICM was higher in groups with more frequent PAC (15.5%/y in group L [n=277] versus 44.0%/y in group M [n=42] versus 71.4%/y in group H [n=62]; log-rank trend P<0.01). Compared with group L, the adjusted hazard ratios for AF detection in groups M and H were 2.11 (95% CI, 1.24-3.58) and 3.23 (95% CI, 2.07-5.04), respectively, and the adjusted odds ratio for high AF burden in groups M and H were 2.57 (95% CI, 1.14-5.74) and 4.25 (2.14-8.47), respectively. CONCLUSIONS: The frequency of PACs was dose-dependently associated with AF detection in patients with cryptogenic stroke.

本文言語英語
ページ(範囲)946-953
ページ数8
ジャーナルStroke
55
4
DOI
出版ステータス出版済み - 01-04-2024
外部発表はい

All Science Journal Classification (ASJC) codes

  • 臨床神経学
  • 循環器および心血管医学
  • 高度および特殊看護

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