Diagnostic and therapeutic impact of ambulatory electrocardiography in acute stroke

Abstract

Detection of paroxysmal atrial fibrillation (PAF) in patients with recent ischemic stroke or TIA suggests a cardioembolic etiology and leads to initiation of oral anticoagulation in suitable candidates. We assessed the diagnostic and therapeutic impact of adding ambulatory electrocardiography (24 hr ECG) to a standardised ischemic stroke workup. Methods : We measured the frequency of detection of PAF in consecutive stroke patients who underwent 24 hr ECG that was not diagnosed clinically or on a standard 12-lead ECG. Results : One hundred forty five ischemic stroke patients were included. 24 hr ECG was obtained in 136 patients (93.8%). Clinically unsuspected PAF was detected on 24 hr ECG in ..