Abstract
Background
Ischaemic stroke or cerebrovascular accident (CVA) due to occult atrial fibrillation (AF) may cause severe morbidity and mortality. Diagnosing occult AF can be challenging and there is no consensus regarding the optimal duration of screening. A 24-hour Holter electrocardiogram (ECG) is frequently employed to detect occult AF following ischaemic CVA.
Objectives
Demonstration of occult AF detection rate using a 24-hour Holter ECG in a primary care setting with descriptive analyses of independent variables to compare AF detected and non-detected patients.
Methods
This retrospective cross-sectional study utilised primary care data and included patients 50 years and older with a new CVA or transient ischaemic attack (TIA) diagnosis followed by a 24-hour Holter examination within 6 months, between 01 January 2013 and 01 June 2019. The analyses included descriptive statistics comparing demographics and clinical characteristics in patients who had AF or Atrial Flutter (AFL) detection to those who did not.
Results
Out of 5015 eligible patients, 66 (1.3%) were diagnosed with AF/AFL, with a number needed to screen of 88.5. Compared with those without AF/AFL detection, those diagnosed were older (75.42 ± 7.89 vs. 69.89 ± 9.88, p = 0.050), had a higher prevalence of hypertension (80.3% vs. 66.8%, p = 0.021) and chronic kidney disease (CKD) (71.2% vs. 44.2%, p < 0.001).
Conclusion
24-hour Holter has a low AF/AFL detection rate. Older persons and those with hypertension or CKD are more likely to be detected with AF/AFL using this method.
Correction Statement
This article has been corrected with minor changes. These changes do not impact the academic content of the article.
Disclosure statement
The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.