Atrial fibrillation burden during in-patient cardiac monitoring after acute ischaemic stroke

Le résumé fourni par la source

BACKGROUND: Atrial fibrillation (AF) burden, the time spent in AF, is increasingly investigated. Data on its characteristics and temporal patterns during early in-hospital telemetry after ischaemic stroke remain limited. PATIENTS AND METHODS: Continuous ECG telemetry was analysed in consecutive patients with MRI-confirmed ischaemic stroke and AF admitted between October 2020 and January 2023 in this observational retrospective cohort trial. Peak AF burden within any 24-h window was categorised as low (≤1 h), medium (>1-6 h), high (> 6 h) or no recorded AF episodes. Associations with clinical and imaging features were assessed using multivariable regression. RESULTS: Among 392 patients with AF-related stroke (median monitoring duration 68 h, median AF burden 12.0 h), AF burden was low in 30 (7.7%), medium in 68 (17.3%), high in 193 (49.2%) and 101 (25.8%) had no recorded episodes. Left-insular stroke was negatively associated with high AF burden (aOR 0.38, 95% CI, 0.15-0.84, P < .05). There was a signal towards a positive association with right-insular stroke (aOR 1.75, 95% CI, 0.90-3.41, P = .09). The laterality difference persisted in continuous-scale analyses. First AF episodes clustered in the early evening among low-burden patients, with early morning episodes least common across all groups. Among patients with known stroke onset (n = 102), 49 exhibited AF confined to the first 48 h. CONCLUSION: AF burden varies widely during early in-hospital monitoring after ischaemic stroke and seems to differ according to insular lesion laterality. Our findings are hypothesis-generating and highlight the need for integrating lesion location, circadian and arrhythmia dynamics to characterise AF burden after stroke.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.