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dc.contributor.authorYan, B
dc.contributor.authorTu, H
dc.contributor.authorLam, C
dc.contributor.authorSwift, C
dc.contributor.authorHo, S
dc.contributor.authorMok, VCT
dc.contributor.authorSui, Y
dc.contributor.authorSharpe, D
dc.contributor.authorGhia, D
dc.contributor.authorJannes, J
dc.contributor.authorDavis, S
dc.contributor.authorLiu, X
dc.contributor.authorFreedman, B
dc.date.accessioned2020-11-17T04:03:53Z
dc.date.available2020-11-17T04:03:53Z
dc.date.issued2020-09-01
dc.identifierpii: jos.2020.00689
dc.identifier.citationYan, B., Tu, H., Lam, C., Swift, C., Ho, S., Mok, V. C. T., Sui, Y., Sharpe, D., Ghia, D., Jannes, J., Davis, S., Liu, X. & Freedman, B. (2020). Nurse Led Smartphone Electrographic Monitoring for Atrial Fibrillation after Ischemic Stroke: SPOT AF. JOURNAL OF STROKE, 22 (3), pp.387-395. https://doi.org/10.5853/jos.2020.00689.
dc.identifier.issn2287-6391
dc.identifier.urihttp://hdl.handle.net/11343/251687
dc.description.abstractBackground and Purpose Paroxysmal atrial fibrillation (PAF) underlying acute stroke frequently evades detection by standard practice, considered to be a combination of routine electrocardiogram (ECG) monitoring, and 24-hour Holter recordings. We hypothesized that nurse-led in-hospital intermittent monitoring approach would increase PAF detection rate. Methods We recruited patients hospitalised for stroke/transient ischemic attack, without history of atrial fibrillation (AF), in a prospective multi-centre observational study. Patients were monitored using a smartphone-enabled handheld ECG (iECG) during routine nursing observations, and underwent 24-hour Holter monitoring according to local practice. The primary outcome was comparison of AF detection by nurse-led iECG versus Holter monitoring in patients who received both tests: secondary outcome was oral anticoagulant commencement at 3-month following PAF detection. Results One thousand and seventy-nine patients underwent iECG monitoring: 294 had iECG and Holter monitoring. AF was detected in 25/294 (8.5%) by iECG, and 8/294 (2.8%) by 24-hour Holter recordings (P<0.001). Median duration from stroke onset to AF detection for iECG was 3 days (interquartile range [IQR], 2 to 6) compared with 7 days (IQR, 6 to 10) for Holter recordings (P=0.02). Of 25 patients with AF detected by iECG, 11 were commenced on oral anticoagulant, compared to 5/8 for Holter. AF was detected in 8.8% (69/785 patients) who underwent iECG recordings only (P=0.8 vs. those who had both iECG and 24-hour Holter). Conclusions Nurse-led in-hospital iECG surveillance after stroke is feasible and effective and detects more PAF earlier and more frequently than routine 24-hour Holter recordings. Screening with iECG could be incorporated into routine post-stroke nursing observations to increase diagnosis of PAF, and facilitate institution of guideline-recommended anticoagulation.
dc.languageEnglish
dc.publisherKOREAN STROKE SOC
dc.rights.urihttps://creativecommons.org/licenses/by-nc/4.0
dc.titleNurse Led Smartphone Electrographic Monitoring for Atrial Fibrillation after Ischemic Stroke: SPOT AF
dc.typeJournal Article
dc.identifier.doi10.5853/jos.2020.00689
melbourne.affiliation.departmentMedicine and Radiology
melbourne.source.titleJournal of stroke
melbourne.source.volume22
melbourne.source.issue3
melbourne.source.pages387-395
dc.rights.licenseCC BY-NC
melbourne.elementsid1468553
melbourne.contributor.authorDavis, Stephen
melbourne.contributor.authorYan, Bernard
melbourne.contributor.authorTu, Hans
dc.identifier.eissn2287-6405
melbourne.accessrightsOpen Access


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