title: Clinically important atrial arrhythmia and stroke risk: a UK-wide online survey among stroke physicians and cardiologists.
abstract: BACKGROUND
  A recording of ≥30 s is required for diagnosis of paroxysmal atrial fibrillation (AF) when using ambulatory electrocardiography (ECG) monitoring. It is unclear if shorter runs of atrial arrhythmia are relevant with regard to stroke risk.
  
  
  OBJECTIVE
  To assess current management of patients with atrial arrhythmia of <30 s duration detected on ambulatory ECG.
  
  
  METHODS
  Online survey.
  
  
  METHODS
  An online survey was sent to cardiologists and stroke physicians in the UK, via their national societies.
  
  
  RESULTS
  A total of 205 clinicians responded to the survey (130 stroke physicians, 64 cardiologists, 11 other). Regarding diagnosis of AF, 87% of responders would accept a single 12-lead ECG. In contrast, only 45% would accept a single episode lasting <30 s detected on ambulatory monitoring. There was more agreement with regard to the decision to anticoagulate. When asked whether they would anticoagulate eight hypothetical patients with non-diagnostic paroxysms of AF, there was a mean agreement of responses of 78.6%, with up to 94.1% agreement for high-risk patients. There was a trend suggesting that stroke physicians were more likely to accept an atrial arrhythmia of <30 s as 'AF' than cardiology specialists [OR 1.63 (95% CI 0.88-3.01), P = 0.12].
  
  
  CONCLUSIONS
  There is a lack of consensus on the diagnosis and management of patients with brief runs of atrial arrhythmia detected on ambulatory ECG. Further research is needed to clarify the risk of stroke in this unique population of patients.
authors.affiliation: From the Acute Stroke Unit, Western Infirmary Glasgow, G11 6NT, UK Institute of Cardiovascular and Medical Sciences, University of Glasgow, G12 8QQ, UK and School of Medicine, University of Glasgow, G12 8QQ, UK.
authors.forename: A J
authors.initials: AJ
authors.lastname: Rankin
authors.affiliation: From the Acute Stroke Unit, Western Infirmary Glasgow, G11 6NT, UK Institute of Cardiovascular and Medical Sciences, University of Glasgow, G12 8QQ, UK and School of Medicine, University of Glasgow, G12 8QQ, UK.
authors.forename: R T
authors.initials: RT
authors.lastname: Tran
authors.affiliation: From the Acute Stroke Unit, Western Infirmary Glasgow, G11 6NT, UK Institute of Cardiovascular and Medical Sciences, University of Glasgow, G12 8QQ, UK and School of Medicine, University of Glasgow, G12 8QQ, UK.
authors.forename: A H
authors.initials: AH
authors.lastname: Abdul-Rahim
authors.affiliation: From the Acute Stroke Unit, Western Infirmary Glasgow, G11 6NT, UK Institute of Cardiovascular and Medical Sciences, University of Glasgow, G12 8QQ, UK and School of Medicine, University of Glasgow, G12 8QQ, UK.
authors.forename: A C
authors.initials: AC
authors.lastname: Rankin
authors.affiliation: From the Acute Stroke Unit, Western Infirmary Glasgow, G11 6NT, UK Institute of Cardiovascular and Medical Sciences, University of Glasgow, G12 8QQ, UK and School of Medicine, University of Glasgow, G12 8QQ, UK.
authors.forename: K R
authors.initials: KR
authors.lastname: Lees
mesh_terms: D000925:Anticoagulants / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000150:complications* / Q000175:diagnosis; D002309:Cardiology; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D009462:Neurology; D010818:Practice Patterns, Physicians'; D012307:Risk Factors; D020521:Stroke / Q000209:etiology* / Q000517:prevention & control; D011795:Surveys and Questionnaires; D006113:United Kingdom
chemical_list: D000925:Anticoagulants