title: Can we improve the early detection of atrial fibrillation in a stroke unit? Detection rate of a monitor with integrated detection software.
abstract: BACKGROUND
  It is unknown whether monitors that include atrial fibrillation recognition software (AF-RS) increase the rate of early atrial fibrillation (AF) detection in acute stroke. We aimed to evaluate the AF detection rate of an AF-RS monitor and compare it with standard monitoring.
  
  
  METHODS
  This was a retrospective, single-centre observational study conducted on consecutive patients with acute transient ischaemic attack or brain infarction attended in a stroke unit (SU) with six beds. Five beds had a standard monitor with a three-lead electrocardiogram (ECG)-tracing monitor that did not automatically detect AF, and one bed had a 12-lead ECG monitor with integrated AF-RS. All patients were monitored for at least 24 h and underwent a daily ECG during their stay in the SU. In case of unknown stroke aetiology, the patients underwent 24 h Holter monitoring.
  
  
  RESULTS
  A total of 76 patients were included: 59 patients in the standard monitor group and 17 patients in the AF-RS monitor group. The mean age was 72.11 (±13.09) years, and 59.2% were men. A total of 20 new cases of AF were identified. The AF-RS monitor showed a higher rate of AF detection than the standard devices (57.1% vs 7.7%, p=0.031). The AF-RS monitor showed sensitivity, specificity, positive predictive value, and negative predictive values of 57.1%, 100%, 100% and 76.9%, respectively. For the standard monitors, these values were 7.7%, 100%, 100% and 79.3%, respectively.
  
  
  CONCLUSIONS
  The monitor with AF-RS demonstrated a higher detection rate for AF than standard ECG monitoring in acute stroke patients in a SU.
authors.affiliation: Department of Neurology and Stroke Centre, La Paz University Hospital; IdiPAZ, Hospital La Paz Institute for Health Research; Autonomous University of Madrid, Spain jjarevaloes@hotmail.com patrindalo@hotmail.com.
authors.forename: Juan Jose
authors.initials: JJ
authors.lastname: Arevalo-Manso
authors.affiliation: Department of Neurology and Stroke Centre, La Paz University Hospital; IdiPAZ, Hospital La Paz Institute for Health Research; Autonomous University of Madrid, Spain.
authors.forename: Patricia
authors.initials: P
authors.lastname: Martínez-Sánchez
authors.affiliation: Department of Neurology and Stroke Centre, La Paz University Hospital; IdiPAZ, Hospital La Paz Institute for Health Research; Autonomous University of Madrid, Spain.
authors.forename: Blanca
authors.initials: B
authors.lastname: Fuentes
authors.affiliation: Department of Neurology and Stroke Centre, La Paz University Hospital; IdiPAZ, Hospital La Paz Institute for Health Research; Autonomous University of Madrid, Spain.
authors.forename: Gerardo
authors.initials: G
authors.lastname: Ruiz-Ares
authors.affiliation: Department of Neurology and Stroke Centre, La Paz University Hospital; IdiPAZ, Hospital La Paz Institute for Health Research; Autonomous University of Madrid, Spain.
authors.forename: Borja Enrique
authors.initials: BE
authors.lastname: Sanz-Cuesta
authors.affiliation: Department of Neurology and Stroke Centre, La Paz University Hospital; IdiPAZ, Hospital La Paz Institute for Health Research; Autonomous University of Madrid, Spain.
authors.forename: Daniel
authors.initials: D
authors.lastname: Prefasi
authors.affiliation: Department of Neurology and Stroke Centre, La Paz University Hospital; IdiPAZ, Hospital La Paz Institute for Health Research; Autonomous University of Madrid, Spain.
authors.forename: Belén
authors.initials: B
authors.lastname: Juarez-Martin
authors.affiliation: Department of Neurology and Stroke Centre, La Paz University Hospital; IdiPAZ, Hospital La Paz Institute for Health Research; Autonomous University of Madrid, Spain.
authors.forename: Azahara
authors.initials: A
authors.lastname: Navarro-Parias
authors.affiliation: Department of Neurology and Stroke Centre, La Paz University Hospital; IdiPAZ, Hospital La Paz Institute for Health Research; Autonomous University of Madrid, Spain.
authors.forename: Pilar
authors.initials: P
authors.lastname: Parrilla-Novo
authors.affiliation: Department of Neurology and Stroke Centre, La Paz University Hospital; IdiPAZ, Hospital La Paz Institute for Health Research; Autonomous University of Madrid, Spain.
authors.forename: Exuperio
authors.initials: E
authors.lastname: Diez-Tejedor
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000175:diagnosis*; D020520:Brain Infarction / Q000503:physiopathology*; D003936:Diagnosis, Computer-Assisted; D042241:Early Diagnosis; D004562:Electrocardiography; D005260:Female; D006801:Humans; D002546:Ischemic Attack, Transient / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012984:Software; D020521:Stroke / Q000503:physiopathology*
keywords: Atrial fibrillation; brain infarction; cardiac monitoring; electrocardiography; stroke unit