Tracking Atrial Fibrillation by 24-Hour Holter ECG in Ischemic Stroke of Unclear Origin, an Experience of the Cardiology Department of the University Hospital of Marrakesh

Abstract

Background: Stroke is a worldwide growing health problem; a significant proportion of acute ischemic strokes occur as the first manifestation of atrial fibrillation. We sought to evaluate the performance of 24-hour rhythm monitoring in detecting paroxysmal atrial fibrillation. Methods: This was a cross-sectional study conducted at the University Hospital of Marrakech, in 174 selected patients with ischemic stroke without clear etiology at baseline subjected to ambulatory Holter monitoring. Results: The overall detection rate for atrial fibrillation was 4.1%, allowing the initiation of anticoagulant therapy in selected patients. Nevertheless, although some degree of success in detecting AF in a short period of monitoring was achieved, it is believed that the prevalence of AF is still underestimated by this screening modality. Conclusion: Tracking atrial fibrillation is a fundamental element in the secondary prevention of stroke; the development of new digital technologies now makes the possibility of long-term heart rhythm monitoring accessible. Numerous ECG recording solutions have been scientifically proven reliable, some are already recommended for the detection of cardiac arrhythmias. The choice of the screening method must be tailored to each individual case.