title: Supraventricular premature beats and short atrial runs predict atrial fibrillation in continuously monitored patients with cryptogenic stroke.
abstract: OBJECTIVE
  Supraventricular premature beats (SPBs) may help to assess the risk of atrial fibrillation (AF) in patients with cryptogenic stroke and therefore guide therapy.
  
  
  METHODS
  An internal loop recorder was implanted in consecutive patients with acute cryptogenic stroke. The occurrence and quantity of SPBs and short supraventricular runs (SVRs) in 24-hour ECG in patients with and without future AF were analyzed. We evaluated the relative risk of the upper quartile of SPB and SVR patients against the remainder and used binary logistic regression to evaluate a possible independent influence of SPBs and SVRs on AF occurrence.
  
  
  RESULTS
  Twelve of 70 included patients (mean age, 59±13 years) experienced development of AF during a mean monitoring duration of 536±212 days. Patients with AF had a median of 22.8 SPBs/h versus 1.2 SPBs/h (P<0.0001) in patients without AF and a median of 0.7 SVRs/h (AF) versus 0 SVR/h (non-AF). Patients in the upper quartile of SPBs (>14.1/h) and SVRs (>0.2/h) demonstrated a relative risk of 4.0 (95% confidence interval, 1.1-14.6; P=0.04) and 6.9 (95% confidence interval, 1.8-26.7; P=0.005) for future AF, respectively. In binary logistic regression, SPBs (P=0.02) and SVRs (P=0.05) remained significant independent predictors for occurrence of AF.
  
  
  CONCLUSIONS
  Numerous SPBs and SVRs demonstrated a high risk for future AF in patients with cryptogenic stroke.
authors.affiliation: From the Division of Electrophysiology, Department of Cardiovascular Medicine (S.K., D.G.D., F.R., S.R., G.F., L.E.) and Department of Neurology (R.D., M.A.R., T.D.), University of Muenster, Muenster, Germany.
authors.forename: Simon
authors.initials: S
authors.lastname: Kochhäuser
authors.forename: Dirk G
authors.initials: DG
authors.lastname: Dechering
authors.forename: Ralf
authors.initials: R
authors.lastname: Dittrich
authors.forename: Florian
authors.initials: F
authors.lastname: Reinke
authors.forename: Martin A
authors.initials: MA
authors.lastname: Ritter
authors.forename: Shahram
authors.initials: S
authors.lastname: Ramtin
authors.forename: Thomas
authors.initials: T
authors.lastname: Duning
authors.forename: Gerrit
authors.initials: G
authors.lastname: Frommeyer
authors.forename: Lars
authors.initials: L
authors.lastname: Eckardt
mesh_terms: D000368:Aged; D001145:Arrhythmias, Cardiac / Q000503:physiopathology*; D001281:Atrial Fibrillation / Q000503:physiopathology* / Q000628:therapy; D018880:Atrial Premature Complexes / Q000503:physiopathology* / Q000628:therapy; D016001:Confidence Intervals; D004562:Electrocardiography; D015716:Electrocardiography, Ambulatory; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012372:ROC Curve; D018570:Risk Assessment; D020521:Stroke / Q000503:physiopathology* / Q000628:therapy
keywords: atrial fibrillation; atrial premature complexes; stroke