Atrial Fibrillation In Stroke Patients Deemed Underestimated

MedicalResearch.com Interview with:

Dr. Rolf Wachter Head Senior physician University of Goettingen Göttingen, Germany

Dr. Rolf Wachter

Dr. Rolf Wachter
Head Senior physician
University of Goettingen
Göttingen, Germany

Medical Research: What is the background for this study? What are the main findings?

Dr. Wachter: Atrial Fibrillation is a known risk factor for stroke, and in stroke patients, it is a strong predictor of adverse outcome, if it is not adequately treated (e.g. by anticoagulation). However, in its paroxysmal form, Atrial Fibrillation (AF) may escape routine diagnostics. We aimed to show that we can increase the number of patients with detected AF if we do more monitoring for atrial fibrillation. As a unique feature of our study, we did not focus on a certain stroke subtype (i.e. cryptogenic stroke), but we aimed to consider all patients >= 60 years in whom the detection of  Atrial Fibrillation has a clinical relevance.

The main finding of our study was that enhanced and prolonged Holter ECG monitoring (3×10 days of monitoring, analysed in a dedicated core lab) tripled the number of detected AF cases (from 4.5 to 13.5 %). 11 patients had to undergo enhanced and prolonged monitoring to find one additional case of Atrial Fibrillation.

Medical Research: What should clinicians and patients take away from your report?

Dr. Wachter:

  1. Atrial Fibrillation in stroke patients in underestimated.
  2. Do not rely on suspected stroke etiology, but perform prolonged monitoring in all patients in whom the detection of  Atrial Fibrillation is of clinical relevance.

Medical Research: What recommendations do you have for future research as a result of this study?

Dr. Wachter: We need to show that prolonged monitoring not only detects more cases ofAtrial Fibrillation, but that we can decrease stroke recurrence by treating atrial fibrillation.

Medical Research: Is there anything else you would like to add?

Dr. Wachter: Although the trial was not powered for “hard endpoints”, we saw numerically less strokes, less TIAs and less deaths in the intervention group (prolonged monitoring), which is very reassuring.

Citation: Presented at the February 2016 International Stroke Conference

Finding Atrial Fibrillation In Stroke Patients – A Multicenter Randomised Evaluation Of Enhanced And Prolonged Holter Monitoring (Find-AFrandomised- Trial)

Dr. Rolf Wachter (2016). Atrial Fibrillation In Stroke Patients Deemed Underestimated 

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