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• W4377014709 abstract "In patients with cryptogenic stroke, long-term monitoring is standard-of-care to exclude atrial tachyarrhythmias. Prior studies have not examined interatrial block (IAB) and other ECG markers paired with long-term continuous monitoring (the current gold standard) to predict likelihood of atrial fibrillation (AF) detection in stroke patients. We aim to elucidate whether there is a correlation between baseline ECG signs at the time of diagnosis of stroke and subsequent AF detected on long-term monitoring with implantable loop recorders. We included 286 patients at Stony Brook University Hospital with stroke admitted between July 2015 and May 2022. All patients had implantable loop recorders placed for long-term monitoring of atrial arrhythmias. Each patient’s ECG at time of admission was analysed by two independent readers to calculate P-wave duration (PWD), P-wave terminal force in V1 (PTFV1), and PR interval. Continuous ECG monitoring was analysed for the presence of atrial fibrillation. This was detected by Lorenz plot of R-R intervals during 2-minute intervals and run through AF detection thresholds of the loop recorder. Minimum duration of follow up was 6 months. Of the 286 patients included in the study, 55 were found to have AF on long-term monitoring. The mean time to AF detection was 247 days. The odds ratio (OR) of detection of AF with P-wave duration ≥ 120 milliseconds was 2.66 (CI 1.38-5.15, P=0.002); the OR for detection of AF with a PR interval > 200ms was 2.24 (CI 1.07-4.69, P=0.016). The odds ratio of the combined criteria of increased PWD and PR interval was 2.94 (CI 1.37-6.30, P=0.018). PTFV1 alone as a marker for AF detection on long-term monitoring was not significant. In combination, increased PWD, increased PTFV1, and increased PR interval demonstrated an OR of 3.22 (CI 1.17-8.89, P=0.012). The difference in mean measured P-wave duration between stroke patients that were found to have AF and those that did not have AF was statistically significant (120ms v. 125.7ms, P<0.001). In patients with ECGs meeting criteria for increased P-wave duration and PR interval at time of admission for cryptogenic stroke, there was an increased likelihood of AF detection during long-term monitoring after discharge. These ECG criteria may have clinical implications as positive predictors for machine-learning programs in the future to identify patients with the highest likelihood of having AF after stroke." @default.
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• W4377014709 date "2023-05-01" @default.
• W4377014709 modified "2023-09-26" @default.
• W4377014709 title "PO-05-136 IN STROKE PATIENTS, DO BASELINE ELECTROCARDIOGRAM FINDINGS CORRELATE WITH DIAGNOSTIC FINDINGS ON LONG-TERM MONITORING WITH IMPLANTABLE LOOP RECORDER?" @default.
• W4377014709 doi "https://doi.org/10.1016/j.hrthm.2023.03.1364" @default.
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