title: Detection of Atrial Fibrillation with Intermittent Handheld Electrocardiogram in Patients with Ischemic Stroke and Transient Ischemic Attack.
abstract: BACKGROUND
  Atrial fibrillation is an important risk factor for recurrent ischemic stroke and transient ischemic attack. Despite routine investigation, some patients' atrial fibrillation remains undetected. Intermittent handheld electrocardiogram (ECG) is an option for extended ECG monitoring aiming at enhancing detection rates. This study aimed to explore the detection rate of atrial fibrillation in stroke and transient ischemic attack patients with intermittent handheld ECG in the clinical setting of Halland Hospital Halmstad.
  
  
  METHODS
  Patients discharged with a diagnosis of ischemic stroke or transient ischemic attack who underwent intermittent handheld ECG recording at Halland Hospital Halmstad from January 1, 2010, to March 31, 2014, were retrospectively studied; 370 patients in total. A positive investigation was defined as either atrial fibrillation for a minimum of 10 seconds or a short irregular supraventricular run.
  
  
  RESULTS
  We found an overall atrial fibrillation detection rate of 7.6% (95% CI 5.1%-10.1%). The detection rate in stroke patients (11.0%) was significantly higher than in transient ischemic attack patients (5.0%), P = .032. The detection rate in patients aged less than 65 years was 4.2%, increasing to 9.8% in patients aged 65 years or older, P = .051.
  
  
  CONCLUSIONS
  This retrospective study shows an atrial fibrillation detection rate of 7.6% in a stroke and transient ischemic attack population using prolonged intermittent monitoring with handheld ECG recording. The compliance to the monitoring was excellent.
authors: Department of Medicine, Halland Hospital, Halmstad, Sweden. Electronic address: ann-sofie.olsson@regionhalland.se.
authors: Ann-Sofie
authors: AS
authors: Olsson
authors: Department of Medicine, Halland Hospital, Halmstad, Sweden.
authors: Johan
authors: J
authors: Engdahl
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D002545:Brain Ischemia / Q000175:diagnosis / Q000209:etiology*; D004562:Electrocardiography / Q000295:instrumentation*; D004867:Equipment Design; D005260:Female; D006801:Humans; D002546:Ischemic Attack, Transient / Q000175:diagnosis / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D058998:Remote Sensing Technology / Q000295:instrumentation*; D012189:Retrospective Studies; D012307:Risk Factors; D012815:Signal Processing, Computer-Assisted; D020521:Stroke / Q000175:diagnosis / Q000209:etiology*; D013548:Sweden; D014159:Transducers; D055815:Young Adult
keywords: Atrial fibrillation; arrhythmia detection; intermittent long-term ECG monitoring; stroke; transient ischemic attack