Atrial Fibrillation in Young Ischemic Stroke Patients: An Underestimated Cause?

作者：Sanak Daniel^*; Hutyra Martin; Kral Michal; Bartkova Andrea; Zapletalova Jana; Fedorco Marian; Veverka Tomas; Vindis David; Dornak Tomas; Skala Tomas; Skoloudik David; Taborsky Milos; Kanovsky Petr

来源：European Neurology, 2015, 73(3-4): 158-163.

DOI：10.1159/000369793

• Young ischemic stroke
• Atrial fibrillation
• ECG Holter monitoring
• Cardiac markers

Background: Undetected atrial fibrillation (AF) is often suspected as the possible cause in patients with cryptogenic ischemic stroke (IS), especially in elderly population. In young IS patients, the prevalence of AF, particularly paroxysmal form, remains still not enough established. Our aim was to assess the presence of AF in young patients using a long-term electrocardiography (ECG) Holter monitoring. Methods: The study set consisted of acute IS patients <= 50 years enrolled in the prospective HISTORY (Heart and Ischemic STrOke Relationship studY) study (NCT01541163). In all patients, admission ECG, serum cardiac markers, transesophageal echocardiography, 24-h and 3-week ECG Holter monitoring were performed. Results: Out of 634 enrolled patients in the HISTORY study, 98 were <= 50 years (56 males, mean age 39.7 +/- 8.4). In total, AF was detected in 10.2% of patients and 70% of them had a paroxysmal form of AF. The elevated serum cardiac markers were present in 70% of patients with detected AF (p = 0.0001). Conclusion: AF was detected in 10.2% of young stroke patients and paroxysmal form of AF prevailed. Using of long-term ECG Holter monitoring improved the detection of AF. Patients with presence of AF had more frequently elevated serum specific cardiac markers.

• 出版日期2015