Beneficial effects of stroke-unit care in stroke patients with atrial fibrillation.
OBJECTIVE
Continuous cardiac monitoring in a stroke unit (SU) may improve detection of atrial fibrillation (AF), and SU care may improve the rate of anticoagulation by better adherence to a standardized treatment protocol in patients with AF. We investigated the effects of the SU on the detection of AF and the rate of warfarin therapy in patients with AF.


METHODS
Acute stroke patients who had been admitted before or after the opening of the SU were included in our study. SU patients were monitored continuously with electrocardiography. Rates of AF and warfarin therapy were compared between patients admitted to the SU (SU group) and those admitted to the general ward (GW) prior to the opening of the SU (GW group).


RESULTS
Total 951 patients had been admitted to the GW prior to the opening of the SU (from January 2000 to November 2002), and 2349 patients to the SU (from January 2003 to December 2008). AF was found in 149 patients (15.7%) in the GW group and in 487 (20.7%) in the SU group. Most of AF detected during admission was paroxysmal AF (84.8%). The frequency of newly detected AF was higher in the SU group than the GW group (2.5% vs. 0.7%, p=0.001). The rate of anticoagulation consideration was also higher in the SU group.


CONCLUSIONS
SU care improved the detection of AF and the rate of anticoagulation consideration in acute stroke patients. Our findings support the benefits of continuous cardiac monitoring in the SU for stroke patients.
Department of Neurology, Yonsei University College of Medicine, Kangdong Hospital, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Korea.
Hye-Yeon
HY
Choi
Joo Hyun
JH
Seo
Jae Hoon
JH
Yang
Young Dae
YD
Kim
Yo Han
YH
Jung
Han Jin
HJ
Cho
Hyo Suk
HS
Nam
Ji Hoe
JH
Heo
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000175:diagnosis*; D002648:Child; D004562:Electrocardiography / Q000379:methods*; D005260:Female; D006748:Hospital Departments; D006801:Humans; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic; D009462:Neurology; D012008:Recurrence; D020521:Stroke / Q000175:diagnosis*; D016896:Treatment Outcome; D014859:Warfarin / Q000627:therapeutic use
D000925:Anticoagulants; D014859:Warfarin