Search results for "Paroxysmal atrial fibrillation"

Abstract WP201: Stroke Patients With Atrial Fibrillation Detected by 72 hour- versus Prolonged ECG-monitoring

2018

Background: Detecting concealed paroxysmal atrial fibrillation (pAF) is a major focus in the workup of ischemic-stroke-patients. The minimal ECG-monitoring for stroke patients was recently expanded from 24 to 72 hours. However, it has been shown that even more prolonged monitoring reveals further pAF-cases. Our aim was to determine, whether known predictors for underlying pAF differ between stroke patients with AF that occurs on shorter (72h) or more prolonged ECG-monitoring (>72h). Methods: The Find-AF RANDOMISED -trial (NCT01855035) evaluated 3x10-day Holter-ECG vs. standard-care in patients > 60 years with acute ischemic strokes with the primary endpoint of novel pAF after 6 month…

Abstract 124: How to Preselect Stroke Patients for Enhanced ECG-Monitoring - Evaluation of Predictors of Paroxysmal Atrial Fibrillation in "Find-AFra…

2019

Background: Detecting concealed paroxysmal atrial fibrillation (pAF) is a major focus of the workup of ischemic-stroke-patients, but requires elaborate ECG-monitoring. We aimed to evaluate pre-specified predictors to determine stroke patients with an increased probability of underlying pAF. We applied cut-off-levels recently suggested by the German Stroke Society 1 . Methods: The Find-AF RANDOMISED -trial (NCT01855035) evaluated 3x10-day Holter-ECG vs. standard-care in 398 patients > 60 years with acute ischemic strokes. The primary endpoint was novel pAF after 6 months. 27 patients in the intervention arm (13.5 %) and 9 patients in the control arm (9.0 %) met the primary endpoint (p=0.…

Abstract WP200: Development and Validation of a Score to Detect Paroxysmal Atrial Fibrillation During Long-term Holter-monitoring After Acute Ischemi…

2018

Introduction: Atrial fibrillation remains one of the most common causes of ischemic stroke. The diagnosis of paroxysmal atrial fibrillation (pAF) frequently escapes routine diagnostic due to its intermittent and asymptomatic occurrence. Currently prolonged monitoring times (72h) are recommended, but did not find their way into everyday practice. Therefore an individual patient selection for prolonged ECG-monitoring might increase the diagnostic yield of pAF in a resource-saving and cost-effective manner. Methods: We used individual patient data from three prospective studies (n total =1556) which performed a prolonged Holter ECG-monitoring (at least 72 h) and centralized data evaluation af…

“Three-level shock” in ablation-refractory paroxysmal atrial fibrillation

1987

His-bundle ablation is a very effective method to control drug-refractory supraventricular arrhythmias. We present a 69-year-old woman with paroxysmal atrial fibrillation, in whom several attempts of unipolar and bipolar His-bundle ablation were ineffective. Ultimately a stable 2/1 atrioventricular block was induced when three successive shocks of 400 W were applied. The first shock was given in that position with the largest His-potential deflection. The other two shocks were applied at catheter positions more distal and more proximal from the first one, respectively. We suppose that the initial lack of success was due to an atypical atrioventricular junction anatomy.

Clinical predictors to identify paroxysmal atrial fibrillation after ischaemic stroke.

2013

Background and purpose Detection of paroxysmal atrial fibrillation (pAF) after an ischaemic cerebrovascular event is of imminent interest, because oral anticoagulation as a highly effective secondary preventive treatment is available. Whereas permanent atrial fibrillation (AF) can be detected during routine electrocardiogram (ECG), longer detection duration will detect more pAF but might be resource consuming. The current study tried to identify clinical predictors for pAF detected during long-term Holter ECG and clinical follow-up. Methods Patients with acute ischaemic stroke were prospectively investigated with an intensified algorithm to detect pAF (7-day Holter ECG, follow-up investigat…

Paroxysmal atrial fibrillation and high degree AV block: use of single-lead VDDR pacing with mode switching.

1998

Dual chamber rate responsive pacing incorporating a mode switching option is increasingly used in patients with chronic paroxysmal atrial fibrillation and high degree AV block. Single-lead VDDR pacemakers have rarely used for this indication. The purpose of this study was to determine their reliability of atrial sensing during atrial fibrillation, the percentage of atrial synchronous ventricular pacing, and the behavior of the sinus rate outside the phases of atrial fibrillation. We studied ten patients with a single-lead VDDR pacemaker implanted for this indication. Follow-up visits were performed at predischarge and after 1, 3, 6, 12, 18, and 24 months. During the mean follow-up period of…

Automatic detection of paroxysmal atrial fibrillation in patients with ischaemic stroke: better than routine diagnostic workup?

2016

Background and purpose Prolonged electrocardiogram (ECG) monitoring after ischaemic stroke increases the diagnostic yield of paroxysmal atrial fibrillation (pAF). In order to facilitate the additional workload involved in ECG analysis due to prolonged monitoring times, we investigated the effectiveness of pAF detection with an automated software algorithm (SA) in comparison to the routine staff-based analysis (RA) during standard stroke-unit care. Therefore, patients with acute ischaemic stroke or transitory ischaemic attack presenting with sinus rhythmus on the admission ECG and no history of atrial fibrillation were prospectively included. Methods A 24-h Holter ECG assessment was performe…

Reliable Paroxysmal Atrial Fibrillation Substrate Assessment During Sinus Rhythm Through Optimal Estimation of Local Activation Waves Dynamics

2020

[EN] The analysis of coronary sinus (CS) electrograms (EGMs) during catheter ablation (CA) of atrial fibrillation (AF) is highly important for AF substrate evaluation. However, channels of the CS catheter may be affected by vigorous cardiac movement and bad contact. This work investigates the most reliable channels in preserving the AF dynamics during sinus rhythm (SR). Local activation waves (LAWs) were detected in 44 bipolar CS recordings of 60-300 seconds duration in 28 paroxysmal AF patients undergoing CA. Recordings consisted of five channels: distal, mid-distal, medial, mid-proximal and proximal. LAW duration, amplitude, area and correlation between dominant morphologies of each chann…

Reliability of Local Activation Waves Features to Characterize Paroxysmal Atrial Fibrillation Substrate During Sinus Rhythm

2020

[EN] Analysis of coronary sinus (CS) electrograms (EGMs) is vastly used for the assessment of the atrial fibrillation (AF) substrate. As a catheter consists of five dipoles (distal, mid-distal, medial, mid-proximal, proximal), results may vary upon the employed channel: myocardial contraction and bad contact are unavoidable factors affecting the recording. This work aims to specify the most reliable channels in catching AF dynamics, using 44 multichannel bipolar CS recordings in sinus rhythm (SR) of paroxysmal AF with 1-5 minutes duration. Local activation waves (LAWs) were detected and main features obtained: duration, amplitude, area and correlation between dominant morphologies of each c…

2015

Background and purpose Silent atrial fibrillation (AF) and tachycardia (AT) are considered precursors of ischaemic stroke. Therefore, detection of paroxysmal atrial rhythm disorders is highly relevant, but is clinically challenging. We aimed to evaluate the diagnostic value of natriuretic peptide levels in the detection of paroxysmal AT/AF in a pilot study. Methods Natriuretic peptide levels were analysed in two independent patient cohorts (162 patients with arterial hypertension or other cardiovascular risk factors and 82 patients with retinal vessel disease). N-terminal-pro-brain natriuretic peptide (NT-proBNP) and BNP were measured before the start of a 7-day Holter monitoring period car…