title: Atrial fibrillation in young ischemic stroke patients: an underestimated cause?
abstract: BACKGROUND
  Undetected atrial fibrillation (AF) is often suspected as the possible cause in patients with cryptogenic ischemic stroke (IS), especially in elderly population. In young IS patients, the prevalence of AF, particularly paroxysmal form, remains still not enough established. Our aim was to assess the presence of AF in young patients using a long-term electrocardiography (ECG) Holter monitoring.
  
  
  METHODS
  The study set consisted of acute IS patients ≤50 years enrolled in the prospective HISTORY (Heart and Ischemic STrOke Relationship studY) study (NCT01541163). In all patients, admission ECG, serum cardiac markers, transesophageal echocardiography, 24-h and 3-week ECG Holter monitoring were performed.
  
  
  RESULTS
  Out of 634 enrolled patients in the HISTORY study, 98 were ≤50 years (56 males, mean age 39.7 ± 8.4). In total, AF was detected in 10.2% of patients and 70% of them had a paroxysmal form of AF. The elevated serum cardiac markers were present in 70% of patients with detected AF (p = 0.0001).
  
  
  CONCLUSIONS
  AF was detected in 10.2% of young stroke patients and paroxysmal form of AF prevailed. Using of long-term ECG Holter monitoring improved the detection of AF. Patients with presence of AF had more frequently elevated serum specific cardiac markers.
authors.affiliation: Comprehensive Stroke Center, Department of Neurology, University Hospital Olomouc, Olomouc, Czech Republic.
authors.forename: Daniel
authors.initials: D
authors.lastname: Šaňák
authors.forename: Martin
authors.initials: M
authors.lastname: Hutyra
authors.forename: Michal
authors.initials: M
authors.lastname: Král
authors.forename: Andrea
authors.initials: A
authors.lastname: Bártková
authors.forename: Jana
authors.initials: J
authors.lastname: Zapletalová
authors.forename: Marián
authors.initials: M
authors.lastname: Fedorco
authors.forename: Tomáš
authors.initials: T
authors.lastname: Veverka
authors.forename: David
authors.initials: D
authors.lastname: Vindiš
authors.forename: Tomáš
authors.initials: T
authors.lastname: Dorňák
authors.forename: Tomáš
authors.initials: T
authors.lastname: Skála
authors.forename: David
authors.initials: D
authors.lastname: Školoudík
authors.forename: Miloš
authors.initials: M
authors.lastname: Táborský
authors.forename: Petr
authors.initials: P
authors.lastname: Kaňovský
mesh_terms: D000328:Adult; D001281:Atrial Fibrillation / Q000150:complications* / Q000453:epidemiology; D004562:Electrocardiography; D015716:Electrocardiography, Ambulatory; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D020521:Stroke / Q000209:etiology*