title: Age-dependent yield of screening for undetected atrial fibrillation in stroke patients: the Find-AF study.
abstract: Diagnosis of paroxysmal atrial fibrillation (AF) in stroke patients is challenging, but highly clinically relevant. The percentage of stroke patients with permanent AF increases with age, but limited data are available for the age-dependent yield of paroxysmal AF by Holter monitoring. Patients with acute cerebral ischemia were included into the prospective observational Find-AF study. Patients free from AF at presentation received 7 day Holter monitoring. We calculated the percentage of otherwise undetected paroxysmal AF and the number needed to screen for age groups under 60 years, and in 5 year clusters from the age of 60 up to 85 and older. 272 patients were included, 43 (15.8 %) had AF at admission, 33 patients with paroxysmal AF were identified by 7 day Holter (n = 29) or medical history (n = 4).The yield of 7 day Holter ECG clearly increased with older age (p = 0.004): <60 years: 5 %, 60-64 years: 5 %, 65-69 years: 7 %, 70-74 years: 11 %, 75-79 years: 13 %, 80-84 years: 25 %, ≥ 85 years: 39 %. The number needed to screen (NNS) to find one patient with paroxysmal AF decreased with age: ≤ 60 years: 18, 60-64 years: 20, 65-69 years: 14, 70-74 years: 9, 75-79 years: 8, 80-84 years: 4, ≥ 85 years: 3, respectively. In patients <65 years, all AF cases were detected by Holter ECG. The percentage of paroxysmal AF in stroke patients increases with age. The 7 day Holter ECG is most efficient in elderly patients.
authors: Clinic for Cardiology and Pneumology, DZHK (German Center for Cardiovascular Research), University of Göttingen, Göttingen, Germany. wachter@med.uni-goettingen.de
authors: Rolf
authors: R
authors: Wachter
authors: Mark
authors: M
authors: Weber-Krüger
authors: Joachim
authors: J
authors: Seegers
authors: Frank
authors: F
authors: Edelmann
authors: Janin
authors: J
authors: Wohlfahrt
authors: Katrin
authors: K
authors: Wasser
authors: Götz
authors: G
authors: Gelbrich
authors: Gerd
authors: G
authors: Hasenfuß
authors: Raoul
authors: R
authors: Stahrenberg
authors: Jan
authors: J
authors: Liman
authors: Klaus
authors: K
authors: Gröschel
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000150:complications* / Q000453:epidemiology; D003627:Data Interpretation, Statistical; D004562:Electrocardiography; D015716:Electrocardiography, Ambulatory; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020521:Stroke / Q000150:complications* / Q000453:epidemiology
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