A meta-analysis of extended ECG monitoring in detection of atrial fibrillation in patients with cryptogenic stroke Article Swipe
Haowen Jiang
,
Shyn Yi Tan
,
Jeremy King Wang
,
Jiaqi Li
,
Tian Ming Tu
,
Vern Hsen Tan
,
Colin Yeo
·
YOU?
·
· 2022
· Open Access
·
· DOI: https://doi.org/10.1136/openhrt-2022-002081
YOU?
·
· 2022
· Open Access
·
· DOI: https://doi.org/10.1136/openhrt-2022-002081
Objective The aim of this systematic review is to evaluate the various modalities available for extended ECG monitoring in the detection of atrial fibrillation (AF) following a cryptogenic stroke. Methods MEDLINE (Ovid), EMBASE (Ovid), Cochrane Central Register of Controlled Trials (CENTRAL) were searched from January 2011 to November 2021. All randomised controlled trials and prospective cohort studies including the use of extended ECG monitoring >24 hours with a minimum duration of AF of 30 s in patients with either cryptogenic strokes or transient ischaemic attacks were included. A random-effects model was used to pool effect estimates of AF detection rates from different ECG modalities. Results 3924 studies were identified, of which 47 were included reporting on a pooled population of 6448 patients with cryptogenic stroke. The pooled AF rate for implantable loop recorders (ILRs) increased from 4.9% (3.0%–7.9%) at 1 month to 38.4% (20.4%–60.2%) at 36 months. Mobile cardiac outpatient telemetry (MCOT) had a significantly higher pooled AF detection rate of 12.8% (8.9%–17.9%) versus 4.9% (3.0%–7.9%) for ILR at 1 month (p<0.0001). Predictors for AF detection include duration of monitoring (p<0.0001) and age (p<0.0001) for ILRs, but only age for MCOTs (p<0.020). Conclusion MCOT has a higher rate of detection at 1 month and is less invasive. Beyond 1 month, compliance becomes a significant limitation for MCOT. MCOT may be a reasonable alternative AF screening tool for patients with cryptogenic stroke if ILR is not available. PROSPERO registration number CRD42022297782.
Related Topics
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Metadata
- Type
- review
- Language
- en
- Landing Page
- https://doi.org/10.1136/openhrt-2022-002081
- https://openheart.bmj.com/content/openhrt/9/2/e002081.full.pdf
- OA Status
- gold
- Cited By
- 13
- References
- 44
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W4298008803
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
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https://openalex.org/W4298008803Canonical identifier for this work in OpenAlex
- DOI
-
https://doi.org/10.1136/openhrt-2022-002081Digital Object Identifier
- Title
-
A meta-analysis of extended ECG monitoring in detection of atrial fibrillation in patients with cryptogenic strokeWork title
- Type
-
reviewOpenAlex work type
- Language
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enPrimary language
- Publication year
-
2022Year of publication
- Publication date
-
2022-09-01Full publication date if available
- Authors
-
Haowen Jiang, Shyn Yi Tan, Jeremy King Wang, Jiaqi Li, Tian Ming Tu, Vern Hsen Tan, Colin YeoList of authors in order
- Landing page
-
https://doi.org/10.1136/openhrt-2022-002081Publisher landing page
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https://openheart.bmj.com/content/openhrt/9/2/e002081.full.pdfDirect link to full text PDF
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YesWhether a free full text is available
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goldOpen access status per OpenAlex
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https://openheart.bmj.com/content/openhrt/9/2/e002081.full.pdfDirect OA link when available
- Concepts
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Medicine, Atrial fibrillation, Internal medicine, Cardiology, Stroke (engine), Meta-analysis, Population, Prospective cohort study, Premature atrial contraction, Cohort, Mechanical engineering, Environmental health, EngineeringTop concepts (fields/topics) attached by OpenAlex
- Cited by
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13Total citation count in OpenAlex
- Citations by year (recent)
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2025: 3, 2024: 5, 2023: 5Per-year citation counts (last 5 years)
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44Number of works referenced by this work
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10Other works algorithmically related by OpenAlex
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