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Searching for Atria...
Searching for Atrial Fibrillation Poststroke : A White Paper of the AF-SCREEN International Collaboration
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- Schnabel, Renate B. (författare)
- University Medical Center Hamburg-Eppendorf,German Centre for Cardiovascular Research
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- Haeusler, Karl Georg (författare)
- University Hospital of Wϋrzburg
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- Healey, Jeffrey S. (författare)
- McMaster University
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- Freedman, Ben (författare)
- University of Sydney
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- Boriani, Giuseppe (författare)
- University of Modena and Reggio Emilia
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- Brachmann, Johannes (författare)
- Klinikum Coburg
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- Brandes, Axel (författare)
- Odense University Hospital
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- Bustamante, Alejandro (författare)
- Vall d'Hebron University Hospital
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- Casadei, Barbara (författare)
- University of Oxford
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- Crijns, Harry J.G.M. (författare)
- Maastricht University Medical Centre
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- Doehner, Wolfram (författare)
- Charité - University Medicine Berlin,German Centre for Cardiovascular Research
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- Engström, Gunnar (författare)
- Lund University,Lunds universitet,Kardiovaskulär forskning - epidemiologi,Forskargrupper vid Lunds universitet,Cardiovascular Research - Epidemiology,Lund University Research Groups
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- Fauchier, Laurent (författare)
- University Hospital of Tours,University Of Tours
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- Friberg, Leif (författare)
- Karolinska Institute
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- Gladstone, David J. (författare)
- University of Toronto,Sunnybrook Health Sciences Centre
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- Glotzer, Taya V. (författare)
- Hackensack University Medical Center
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- Goto, Shinya (författare)
- Tokai University
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- Hankey, Graeme J. (författare)
- Sir Charles Gairdner Hospital,University of Western Australia, Perth
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- Harbison, Joseph A. (författare)
- Trinity College Dublin
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- Hobbs, F. D.Richard (författare)
- University of Oxford
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- Johnson, Linda S.B. (författare)
- Lund University,Lunds universitet,Kardiovaskulär forskning - epidemiologi,Forskargrupper vid Lunds universitet,Cardiovascular Research - Epidemiology,Lund University Research Groups
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- Kamel, Hooman (författare)
- Cornell University
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- Kirchhof, Paulus (författare)
- University of Birmingham,University Hospitals Birmingham
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- Korompoki, Eleni (författare)
- Imperial College London
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- Krieger, Derk W. (författare)
- Mohammed Bin Rashid University of Medicine and Health Sciences,Mediclinic City Hospital, Dubai
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- Lip, Gregory Y.H. (författare)
- Liverpool Heart and Chest Hospital,University of Liverpool
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- Løchen, Maja Lisa (författare)
- University Hospital of North Norway
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- Mairesse, Georges H. (författare)
- Cliniques du Sud Luxembourg
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- Montaner, Joan (författare)
- Vall d'Hebron University Hospital
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- Neubeck, Lis (författare)
- Edinburgh Napier University
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- Ntaios, George (författare)
- University of Thessaly
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- Piccini, Jonathan P. (författare)
- Duke Clinical Research Institute (DCRI),Duke University Medical Center
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- Potpara, Tatjana S. (författare)
- University of Belgrade
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- Quinn, Terence J. (författare)
- University of Glasgow
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- Reiffel, James A. (författare)
- Columbia University
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- Ribeiro, Antonio Luiz Pinho (författare)
- Federal University of Minas Gerais,Hospital das Clínicas da Universidade Federal de Minas Gerais
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- Rienstra, Michiel (författare)
- University Medical Center Groningen,University of Groningen
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- Rosenqvist, Mårten (författare)
- Karolinska Institute
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- Sakis, Themistoclakis (författare)
- Venice-Mestre Hospital (Ospedale dell'Angelo)
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- Sinner, Moritz F. (författare)
- University Hospital Munich,German Centre for Cardiovascular Research,Ludwig-Maximilian University of Munich
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- Svendsen, Jesper Hastrup (författare)
- University of Copenhagen,Copenhagen University Hospital
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- Van Gelder, Isabelle C. (författare)
- University of Groningen,University Medical Center Groningen
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- Wachter, Rolf (författare)
- German Centre for Cardiovascular Research,University Hospital Leipzig,University Medical Center Göttingen
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- Wijeratne, Tissa (författare)
- Sunshine Hospital, St Albans,University of Melbourne
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- Yan, Bernard (författare)
- Royal Melbourne Hospital
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(creator_code:org_t)
- 2019
- 2019
- Engelska 17 s.
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Ingår i: Circulation. - 1524-4539. ; 140:22, s. 1834-1850
- Relaterad länk:
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http://dx.doi.org/10...
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https://lup.lub.lu.s...
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https://doi.org/10.1...
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http://kipublication...
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Abstract
Ämnesord
Stäng
- Cardiac thromboembolism attributed to atrial fibrillation (AF) is responsible for up to one-third of ischemic strokes. Stroke may be the first manifestation of previously undetected AF. Given the efficacy of oral anticoagulants in preventing AF-related ischemic strokes, strategies of searching for AF after a stroke using ECG monitoring followed by oral anticoagulation (OAC) treatment have been proposed to prevent recurrent cardioembolic strokes. This white paper by experts from the AF-SCREEN International Collaboration summarizes existing evidence and knowledge gaps on searching for AF after a stroke by using ECG monitoring. New AF can be detected by routine plus intensive ECG monitoring in approximately one-quarter of patients with ischemic stroke. It may be causal, a bystander, or neurogenically induced by the stroke. AF after a stroke is a risk factor for thromboembolism and a strong marker for atrial myopathy. After acute ischemic stroke, patients should undergo 72 hours of electrocardiographic monitoring to detect AF. The diagnosis requires an ECG of sufficient quality for confirmation by a health professional with ECG rhythm expertise. AF detection rate is a function of monitoring duration and quality of analysis, AF episode definition, interval from stroke to monitoring commencement, and patient characteristics including old age, certain ECG alterations, and stroke type. Markers of atrial myopathy (eg, imaging, atrial ectopy, natriuretic peptides) may increase AF yield from monitoring and could be used to guide patient selection for more intensive/prolonged poststroke ECG monitoring. Atrial myopathy without detected AF is not currently sufficient to initiate OAC. The concept of embolic stroke of unknown source is not proven to identify patients who have had a stroke benefitting from empiric OAC treatment. However, some embolic stroke of unknown source subgroups (eg, advanced age, atrial enlargement) might benefit more from non-vitamin K-dependent OAC therapy than aspirin. Fulfilling embolic stroke of unknown source criteria is an indication neither for empiric non-vitamin K-dependent OAC treatment nor for withholding prolonged ECG monitoring for AF. Clinically diagnosed AF after a stroke or a transient ischemic attack is associated with significantly increased risk of recurrent stroke or systemic embolism, in particular, with additional stroke risk factors, and requires OAC rather than antiplatelet therapy. The minimum subclinical AF duration required on ECG monitoring poststroke/transient ischemic attack to recommend OAC therapy is debated.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
Nyckelord
- anticoagulants
- atrial fibrillation
- cardiomyopathies
- electrocardiography
- stroke
Publikations- och innehållstyp
- art (ämneskategori)
- ref (ämneskategori)
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Till lärosätets databas
- Av författaren/redakt...
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Schnabel, Renate ...
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Haeusler, Karl G ...
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Healey, Jeffrey ...
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Freedman, Ben
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Boriani, Giusepp ...
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Brachmann, Johan ...
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visa fler...
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Brandes, Axel
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Bustamante, Alej ...
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Casadei, Barbara
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Crijns, Harry J. ...
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Doehner, Wolfram
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Engström, Gunnar
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Fauchier, Lauren ...
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Friberg, Leif
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Gladstone, David ...
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Glotzer, Taya V.
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Goto, Shinya
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Hankey, Graeme J ...
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Harbison, Joseph ...
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Hobbs, F. D.Rich ...
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Johnson, Linda S ...
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Kamel, Hooman
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Kirchhof, Paulus
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Korompoki, Eleni
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Krieger, Derk W.
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Lip, Gregory Y.H ...
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Løchen, Maja Lis ...
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Mairesse, George ...
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Montaner, Joan
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Neubeck, Lis
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Ntaios, George
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Piccini, Jonatha ...
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Potpara, Tatjana ...
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Quinn, Terence J ...
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Reiffel, James A ...
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Ribeiro, Antonio ...
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Rienstra, Michie ...
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Rosenqvist, Mårt ...
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Sakis, Themistoc ...
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Sinner, Moritz F ...
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Svendsen, Jesper ...
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Van Gelder, Isab ...
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Wachter, Rolf
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Wijeratne, Tissa
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Yan, Bernard
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- Om ämnet
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- MEDICIN OCH HÄLSOVETENSKAP
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MEDICIN OCH HÄLS ...
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och Klinisk medicin
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och Kardiologi
- Artiklar i publikationen
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Circulation
- Av lärosätet
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Lunds universitet
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Karolinska Institutet