Software‐based analysis of 1‐hour Holter ECG to select for prolonged ECG monitoring after stroke Article Swipe
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· 2020
· Open Access
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· DOI: https://doi.org/10.1002/acn3.51157
Objective Identification of ischemic stroke patients at high risk for paroxysmal atrial fibrillation (pAF) during 72 hours Holter ECG might be useful to individualize the allocation of prolonged ECG monitoring times, currently not routinely applied in clinical practice. Methods In a prospective multicenter study, the first analysable hour of raw ECG data from prolonged 72 hours Holter ECG monitoring in 1031 patients with acute ischemic stroke/TIA presenting in sinus rhythm was classified by an automated software (AA) into “no risk of AF” or “risk of AF” and compared to clinical variables to predict AF during 72 hours Holter‐ECG. Results pAF was diagnosed in 54 patients (5.2%; mean age: 78 years; female 56%) and was more frequently detected after 72 hours in patients classified by AA as “risk of AF” (n = 21, 17.8%) compared to “no risk of AF” (n = 33, 3.6%). AA‐based risk stratification as “risk of AF” remained in the prediction model for pAF detection during 72 hours Holter ECG (OR3.814, 95% CI 2.024‐7.816, P < 0.001), in addition to age (OR1.052, 95% CI 1.021‐1.084, P = 0.001), NIHSS (OR 1.087, 95% CI 1.023‐1.154, P = 0.007) and prior treatment with thrombolysis (OR2.639, 95% CI 1.313‐5.306, P = 0.006). Similarly, risk stratification by AA significantly increased the area under the receiver operating characteristic curve (AUC) for prediction of pAF detection compared to a purely clinical risk score (AS5F alone: AUC 0.751; 95% CI 0.724‐0.778; AUC for the combination: 0.789, 95% CI 0.763‐0.814; difference between the AUC P = 0.022). Interpretation Automated software‐based ECG risk stratification selects patients with high risk of AF during 72 hours Holter ECG and adds predictive value to common clinical risk factors for AF prediction.
Related Topics
- Type
- article
- Language
- en
- Landing Page
- https://doi.org/10.1002/acn3.51157
- OA Status
- gold
- Cited By
- 5
- References
- 37
- Related Works
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- OpenAlex ID
- https://openalex.org/W3081638000
Raw OpenAlex JSON
- OpenAlex ID
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https://openalex.org/W3081638000Canonical identifier for this work in OpenAlex
- DOI
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https://doi.org/10.1002/acn3.51157Digital Object Identifier
- Title
-
Software‐based analysis of 1‐hour Holter ECG to select for prolonged ECG monitoring after strokeWork title
- Type
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articleOpenAlex work type
- Language
-
enPrimary language
- Publication year
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2020Year of publication
- Publication date
-
2020-08-30Full publication date if available
- Authors
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Sonja Gröschel, Björn Lange, Katrin Wasser, Marianne Hahn, Rolf Wachter, Klaus Gröschel, Timo UphausList of authors in order
- Landing page
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https://doi.org/10.1002/acn3.51157Publisher landing page
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YesWhether a free full text is available
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goldOpen access status per OpenAlex
- OA URL
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https://doi.org/10.1002/acn3.51157Direct OA link when available
- Concepts
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Medicine, Atrial fibrillation, Thrombolysis, Internal medicine, Risk stratification, Cardiology, Receiver operating characteristic, Holter monitor, Stroke (engine), Premature atrial contraction, Sinus rhythm, Prospective cohort study, Area under the curve, Electrocardiography, Myocardial infarction, Mechanical engineering, EngineeringTop concepts (fields/topics) attached by OpenAlex
- Cited by
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5Total citation count in OpenAlex
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2025: 1, 2024: 1, 2023: 1, 2022: 1, 2021: 1Per-year citation counts (last 5 years)
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37Number of works referenced by this work
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10Other works algorithmically related by OpenAlex
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| abstract_inverted_index.rhythm | 70 |
| abstract_inverted_index.stroke | 5 |
| abstract_inverted_index.study, | 44 |
| abstract_inverted_index.times, | 31 |
| abstract_inverted_index.useful | 22 |
| abstract_inverted_index.years; | 110 |
| abstract_inverted_index.0.001), | 170, 181 |
| abstract_inverted_index.0.006). | 202 |
| abstract_inverted_index.0.022). | 252 |
| abstract_inverted_index.Methods | 39 |
| abstract_inverted_index.Results | 99 |
| abstract_inverted_index.applied | 35 |
| abstract_inverted_index.between | 247 |
| abstract_inverted_index.factors | 279 |
| abstract_inverted_index.predict | 93 |
| abstract_inverted_index.selects | 259 |
| abstract_inverted_index.“risk | 84, 127, 148 |
| abstract_inverted_index.Abstract | 0 |
| abstract_inverted_index.addition | 172 |
| abstract_inverted_index.clinical | 37, 90, 228, 277 |
| abstract_inverted_index.compared | 88, 134, 224 |
| abstract_inverted_index.detected | 117 |
| abstract_inverted_index.ischemic | 4, 65 |
| abstract_inverted_index.patients | 6, 62, 105, 122, 260 |
| abstract_inverted_index.receiver | 214 |
| abstract_inverted_index.remained | 151 |
| abstract_inverted_index.software | 76 |
| abstract_inverted_index.(OR1.052, | 175 |
| abstract_inverted_index.(OR2.639, | 196 |
| abstract_inverted_index.(OR3.814, | 164 |
| abstract_inverted_index.Automated | 254 |
| abstract_inverted_index.Objective | 1 |
| abstract_inverted_index.automated | 75 |
| abstract_inverted_index.currently | 32 |
| abstract_inverted_index.detection | 158, 223 |
| abstract_inverted_index.diagnosed | 102 |
| abstract_inverted_index.increased | 209 |
| abstract_inverted_index.operating | 215 |
| abstract_inverted_index.practice. | 38 |
| abstract_inverted_index.prolonged | 28, 54 |
| abstract_inverted_index.routinely | 34 |
| abstract_inverted_index.treatment | 193 |
| abstract_inverted_index.variables | 91 |
| abstract_inverted_index.AA‐based | 144 |
| abstract_inverted_index.Similarly, | 203 |
| abstract_inverted_index.allocation | 26 |
| abstract_inverted_index.analysable | 47 |
| abstract_inverted_index.classified | 72, 123 |
| abstract_inverted_index.difference | 246 |
| abstract_inverted_index.frequently | 116 |
| abstract_inverted_index.monitoring | 30, 59 |
| abstract_inverted_index.paroxysmal | 11 |
| abstract_inverted_index.prediction | 154, 220 |
| abstract_inverted_index.predictive | 273 |
| abstract_inverted_index.presenting | 67 |
| abstract_inverted_index.stroke/TIA | 66 |
| abstract_inverted_index.multicenter | 43 |
| abstract_inverted_index.prediction. | 282 |
| abstract_inverted_index.prospective | 42 |
| abstract_inverted_index.combination: | 241 |
| abstract_inverted_index.fibrillation | 13 |
| abstract_inverted_index.thrombolysis | 195 |
| abstract_inverted_index.Holter‐ECG. | 98 |
| abstract_inverted_index.individualize | 24 |
| abstract_inverted_index.significantly | 208 |
| abstract_inverted_index.0.724‐0.778; | 237 |
| abstract_inverted_index.0.763‐0.814; | 245 |
| abstract_inverted_index.1.021‐1.084, | 178 |
| abstract_inverted_index.1.023‐1.154, | 187 |
| abstract_inverted_index.1.313‐5.306, | 199 |
| abstract_inverted_index.2.024‐7.816, | 167 |
| abstract_inverted_index.Identification | 2 |
| abstract_inverted_index.Interpretation | 253 |
| abstract_inverted_index.characteristic | 216 |
| abstract_inverted_index.stratification | 146, 205, 258 |
| abstract_inverted_index.software‐based | 255 |
| cited_by_percentile_year.max | 95 |
| cited_by_percentile_year.min | 89 |
| corresponding_author_ids | https://openalex.org/A5073663956, https://openalex.org/A5034245477, https://openalex.org/A5051127640, https://openalex.org/A5060695490, https://openalex.org/A5090498630, https://openalex.org/A5060520647, https://openalex.org/A5068649094 |
| countries_distinct_count | 1 |
| institutions_distinct_count | 7 |
| corresponding_institution_ids | https://openalex.org/I197323543, https://openalex.org/I4210094062, https://openalex.org/I4210116730, https://openalex.org/I4210125843, https://openalex.org/I4210127591 |
| sustainable_development_goals[0].id | https://metadata.un.org/sdg/3 |
| sustainable_development_goals[0].score | 0.6700000166893005 |
| sustainable_development_goals[0].display_name | Good health and well-being |
| citation_normalized_percentile.value | 0.6747182 |
| citation_normalized_percentile.is_in_top_1_percent | False |
| citation_normalized_percentile.is_in_top_10_percent | False |