Detektion von Vorhofflimmern beim Schlaganfall

Abstract

Approximately every fourth stroke results from cardiac embolism. Atrial fibrillation has been recognized as a common cause for thromboembolic stroke. Detection of unknown atrial fibrillation is an important clinical challenge, as anticoagulation may effectively reduce the risk of recurrent ischemic stroke. In all patients with a cryptogenic stroke 24-h Holter monitoring should be performed in addition to a standard ECG to detect paroxysmal atrial fibrillation. In addition, it is useful to pay attention to atrial fibrillation during continuous bedside ECG monitoring on the stroke unit and in pacemaker interrogation. The indication for longer ECG monitoring by implantable loop recorders may be considered individually based on the expected probability of atrial fibrillation. The potential benefit of these devices is currently being evaluated in clinical trials.

A self-management support intervention for patients with atrial fibrillation: a randomized controlled pilot trial

“…The effective management of signs and symptoms is a process that starts with detection and interpretation, then leads to the selection of a strategy, and ends with an evaluation of the chosen strategy [33]. The manifestation and awareness of AF symptoms (such as lethargy, palpitations, dyspnea, chest tightness, sleeping difficulties, and psychosocial distress [5]) can vary greatly from symptom-free to a massive impairment of daily life [34][35][36]. AF recurrences can frequently be asymptomatic, and while patient reported symptoms are considered to be an inaccurate estimation [37], an irregular pulse, regarded as a clinical manifestation of or sign for AF, can be a measurable indicator of the disease or recurrence [38,39] that can be detected through pulse palpation.…”