Prolonged Cardiac Monitoring for Detection of Paroxysmal Atrial Fibrillation After Cerebral Ischemia

Rabinstein, Alejandro A.

doi:10.1161/strokeaha.113.003389

Cited by 27 publications

(15 citation statements)

References 59 publications

(63 reference statements)

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“…Similar to other studies, our method of ascertaining atrial fibrillation likely underestimates cases of paroxysmal atrial fibrillation which are often asymptomatic. Additional individuals may have developed atrial fibrillation after inclusion in the study or may harbor undetected paroxysmal atrial fibrillation only recognizable by prolonged ambulatory monitoring [48]. We did not distinguish which patients had persistent versus paroxysmal atrial fibrillation.…”

Section: Discussionmentioning

confidence: 99%

Atrial fibrillation, cognitive impairment, and neuroimaging

Graff‐Radford

Madhavan

Vemuri

et al. 2015

Alzheimer's & Dementia

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INTRODUCTION The objective of our study was to investigate cross-sectional associations of atrial fibrillation with neuroimaging measures of cerebrovascular disease and Alzheimer’s disease, and their interactions with mild cognitive impairment (MCI). METHODS MRI scans of individuals from a population-based study were analyzed for infarctions, total grey matter, hippocampal and white matter hyperintensity (WMH) volumes. A subsample underwent PET imaging. RESULTS Atrial fibrillation was associated with infarctions and lower total grey matter volume. Compared to subjects with no atrial fibrillation and no infarction, the odds ratio (95% confidence intervals) for MCI was 2.99 (1.57, 5.70; p = 0.001) among participants with atrial fibrillation and infarction, 0.90 (0.45, 1.80; p= 0.77) for atrial fibrillation and no infarction, and 1.50 (0.96, 2.34; p= 0.08) for no atrial fibrillation and any infarction. DISCUSSION Participants with both atrial fibrillation and infarction are more likely to have MCI than participants with either infarction or atrial fibrillation alone.

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Section: Discussionmentioning

confidence: 99%

Atrial fibrillation, cognitive impairment, and neuroimaging

Graff‐Radford

Madhavan

Vemuri

et al. 2015

Alzheimer's & Dementia

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“…On the other side, we have recently learned, from studies in cryptogenic stroke, that the kind of ECG monitoring may significantly affect the detection of paroxysmal AF. 44,45 As recently outlined by Rabinstein,46 in relation to secondary stroke prevention, the issue is now to establish whether there is a minimum AF burden threshold below which the risk of stroke does not justify anticoagulation, that is, is a single episode of AF lasting <30 seconds for a monitoring period of 3 weeks a sufficient indication for life-long anticoagulation? The issue of AF burden warrants further investigation also in relation to the cognitive consequences of AF.…”

Section: Discussionmentioning

confidence: 99%

Atrial Fibrillation and Cognition

Poggesi

Inzitari

Pantoni

2015

Stroke

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“…Older age is associated with an increased risk of AF [52]. In both the EMBRACE and CRYSTAL AF studies, older age was associated with subsequent AF in cryptogenic stroke [26•, 53].…”

Section: Predictors Of Afmentioning

confidence: 99%

Paroxysmal Atrial Fibrillation: Novel Strategies for Monitoring and Implications for Treatment in Stroke

Silverman

2016

Curr Treat Options Cardio Med

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In cryptogenic stroke, prolonged cardiac monitoring is often employed to search for and diagnose atrial fibrillation (AF). Multiple monitoring modalities with multiple durations of monitoring exist. Finding atrial fibrillation after an ischemic stroke is extremely important as anticoagulation is the standard of care and results in the lowest stroke recurrence rate. The protocol at our institution is to carry out 30-day mobile cardiac outpatient telemetry (MCOT) in all patients with cryptogenic stroke. If this MCOT fails to reveal AF, yet the suspicion is high based on the presence of clinical, biochemical, electrocardiographic, and echocardiographic factors, we may proceed to use an implantable cardiac monitor. When AF is diagnosed after cryptogenic stroke, regardless of its duration and assuming no contraindications exist, anticoagulation is recommended with either warfarin or one of the DOACs (direct oral anticoagulants).

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Prolonged Cardiac Monitoring for Detection of Paroxysmal Atrial Fibrillation After Cerebral Ischemia

Cited by 27 publications

References 59 publications

Atrial fibrillation, cognitive impairment, and neuroimaging

Atrial fibrillation, cognitive impairment, and neuroimaging

Atrial Fibrillation and Cognition

Paroxysmal Atrial Fibrillation: Novel Strategies for Monitoring and Implications for Treatment in Stroke

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