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Please use this identifier to cite or link to this item: http://hdl.handle.net/1942/23237

Title: Detection of Atrial Fibrillation Among Patients With Stroke Due to Large or Small Vessel Disease: A Meta-Analysis
Authors: Demeestere, Jelle
Fieuws, Steffen
Lansberg, Maarten G.
Lemmens, Robin
Issue Date: 2016
Publisher: WILEY-BLACKWELL
Citation: JOURNAL OF THE AMERICAN HEART ASSOCIATION, 5(9) (Art N° e004151)
Abstract: Background-Recent trials have demonstrated that extended cardiac monitoring increases the yield of paroxysmal atrial fibrillation (AF) detection in patients with cryptogenic stroke. The utility of extended cardiac monitoring is uncertain among patients with stroke caused by small and large vessel disease. We conducted a meta-analysis to estimate the yield of AF detection in this population. Methods and Results-We searched PubMed, Cochrane, and SCOPUS databases for studies on AF detection in stroke patients and excluded studies restricted to patients with cryptogenic stroke or transient ischemic attack. We abstracted AF detection rates for 3 populations grouped by stroke etiology: large vessel stroke, small vessel stroke, and stroke of undefined etiology (a mixture of cryptogenic, small vessel, large vessel, and other stroke etiologies). Our search yielded 30 studies (n=5687). AF detection rates were similar in patients with large vessel (2.2%, 95% CI 0.3-5.5; n=830) and small vessel stroke (2.4%, 95% CI 0.4-6.1; n=520). No studies had a monitoring duration longer than 7 days. The yield of AF detection in the undefined stroke population was higher (9.2%; 95% CI 7.1-11.5) compared to small vessel stroke (P=0.02) and large vessel stroke (P=0.02) populations. Conclusions-AF detection rate is similar in patients with small and large vessel strokes (2.2-2.4%). Because no studies reported on extended monitoring (>7 days) in these stroke populations, we could not estimate the yield of AF detection with long-term cardiac monitoring. Randomized controlled trials are needed to examine the utility of AF detection with long-term cardiac monitoring (>7 days) in this patient population.
Notes: [Demeestere, Jelle; Lemmens, Robin] Univ Hosp Leuven, Dept Neurol, Leuven, Belgium. [Fieuws, Steffen] Univ Leuven, KU Leuven, Interuniv Inst Biostat & Stat Bioinformat, Leuven, Belgium. [Fieuws, Steffen] Univ Hasselt, Leuven, Belgium. [Lansberg, Maarten G.] Stanford Univ, Stanford Stroke Ctr, Stanford, CA USA. [Lemmens, Robin] Univ Leuven, KU Leuven, Dept Neurosci, Expt Neurol, Leuven, Belgium. [Lemmens, Robin] Leuven Res Inst Neurosci & Dis LIND, Leuven, Belgium. [Lemmens, Robin] VIB, Vesalius Res Ctr, Lab Neurobiol, Leuven, Belgium.
URI: http://hdl.handle.net/1942/23237
DOI: 10.1161/JAHA.116.004151
ISI #: 000386716900056
ISSN: 2047-9980
Category: A1
Type: Journal Contribution
Appears in Collections: Research publications

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