Computer-Assisted Electrocardiogram Analysis Improves Risk Assessment of Underlying Atrial Fibrillation in Cryptogenic Stroke
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Le résumé fourni par la source
Background: The detection of underlying paroxysmal atrial fibrillation (AF) in patients with cryptogenic stroke (CS) can be challenging, and there is great interest in finding predictors of its hidden presence. The recent development of sophisticated software has enhanced the diagnostic and prognostic performance of the 12-lead electrocardiogram (ECG). Our aim was to assess the additional role of a computer-assisted ECG analysis in identifying predictors of AF in patients with CS. Methods: Sixty-seven patients with ischemic stroke or high-risk transient ischemic attack of unknown etiology were prospectively studied. Their 12-lead digitized ECG was analyzed with dedicated software, quantifying 468 morphological variables. The main clinical, biochemical, and echocardiographic variables were also collected. At discharge, patients were monitored with a wearable Holter for 15 days, and the primary outcome was the detection of AF. Results: The median age was 80 (interquartile range (IQR): 73 - 84) and AF was detected in 21 patients (31.3%). After preselecting significant ECG variables from the univariate analysis, a multivariate regression including other significant clinical, biochemical and echocardiographic predictors of AF was performed. Among the automatically analyzed ECG parameters, the amplitude of the R wave in V1 (V1_ramp) was significantly associated with the outcome. The best model to predict AF was composed of age, N-terminal B-type natriuretic peptide (NT-proBNP), left atrial reservoir strain (LASr) and V1_ramp. This model showed good discrimination capacity (corrected Somer’s Dxy: 0.907, Brier’s B: 0.079, area under the curve (AUC): 0.941) and performed better than the same model without the ECG variable (Somer’s Dxy: 0.827, Brier’s B: 0.119, AUC: 0.896). Conclusions: The addition of computer-assisted ECG analysis can help stratify the risk of AF in the challenging clinical setting of CS.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Computer-Assisted Electrocardiogram Analysis Improves Risk Assessment of Underlying Atrial Fibrillation in Cryptogenic Stroke
- Date Crossref
- 01/04/2025
- Éditeur
- Elmer Press, Inc.
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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Ospedale Santa Chiara pays non établi dans la noticeÉtablissement de santé
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Hospital Universitario de La Princesa Cardiology Department pays non établi dans la noticeÉtablissement de santé
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Universidad Autónoma de Madrid pays non établi dans la noticeUniversité ou école supérieure
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Hospital Universitario Ramón y Cajal Cardiology Department pays non établi dans la noticeÉtablissement de santé
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National University of Quilmes Science and Technology Department pays non établi dans la noticeUniversité ou école supérieure
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Consejo Nacional de Investigaciones Científicas y Técnicas pays non établi dans la noticeOrganisme public
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Cardiology Department pays non établi dans la noticeInstitution
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Instituto de Investigacion Sanitaria Data Analysis Unit pays non établi dans la noticeStructure de recherche
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IIS-IP pays non établi dans la noticeInstitution
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These two authors contributed to the present work equally pays non établi dans la noticeInstitution
Ospedale Santa Chiara, Cardiology Department — Hospital Universitario de La Princesa et Universidad Autónoma de Madrid, avec 7 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.