Arrhythmias & electrophysiology
Predictors of paroxysmal atrial fibrillation in patients with a cryptogenic stroke: Selecting patients for long-term rhythm monitoring
Authors' conclusion
The ACL score enables clinicians to better predict which patients are more likely to be diagnosed with device-detected AF after a cryptogenic stroke.
Study context
- Population
- Patients admitted with cryptogenic stroke or TIA who underwent long-term rhythm monitoring with an implantable cardiac monitor, Montefiore Medical Center, May 2017–June 2022
- Exposure
- ACL score vs CHA2DS2-VASc and C2HEST scores for predicting device-detected atrial fibrillation (AF)
- Outcome
- Predictors of clinically significant AF (device-detected AF)
Methodological detailssingle-centre
- Single-centre
Main finding
As reported in the abstract
Variables positively associated with clinically significant AF
- Age
- P <.001
- Race
- P = .022
- DM
- P = .026
- Chronic obstructive pulmonary disease
- P = .012
- Presence of atrial runs
- P = .003
- Number of atrial runs per 24 h
- P <.001
- Total atrial run beats per 24 h
- P <.001
- Beats in longest atrial run
- P <.001
- Left atrial enlargement
- P = .007
- At least mild mitral regurgitation
- P = .009
Observational data: associations, not effects.
Further findings
Prediction of device-detected AF by risk score
- ACL score superior to CHA2DS2-VASc and comparable to C2HEST
Original publication
Predictors of paroxysmal atrial fibrillation in patients with a cryptogenic stroke: Selecting patients for long-term rhythm monitoring. Heart Rhythm. Published 4 July 2024. doi:10.
Summarised from the published abstract; every number is checked against it