Mobile Single-Lead Electrocardiogram Technology for Atrial Fibrillation Detection in Acute Ischemic Stroke Patients.

Marta Leńska-Mieciek,Natalia Dociak,Marcin Kowalewski,Andrzej Osiecki,Aleksandra Kuls-Oszmaniec,Krzysztof Sarwiński,Urszula Fiszer

doi:10.3390/jcm11030665

Marta Leńska-Mieciek, Natalia Dociak + Show 5 more

Open Access

https://doi.org/10.3390/jcm11030665

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Abstract

(1) Background: AliveCor KardiaMobile (KM) is a portable electrocardiography recorder for detection of atrial fibrillation (AF). The aim of the study was to define the group of acute ischemic stroke (AIS) patients who can use the KM device and assess the diagnostic test accuracy. (2) Methods: the AIS patients were recruited to the study. Thirty-second single-lead electrocardiogram (ECG) usages were recorded on demand for three days using KM portable device. Each KM ECG record was verified by a cardiologist. The feasibility was evaluated using operationalization criteria. (3) Results: the recruitment rate among AIS patients was 26.3%. The withdrawal rate before the start of the intervention was 26%. The withdrawal rate after the start of the intervention was 6%. KM device detected AF in 2.8% of AIS patients and in 2.2% of ECG records. Cardiologist confirmed the AF in 0.3% AIS patients. Sensitivity and specificity of KM for AF was 100% and 98.3%, respectively. (4) Conclusions: the results of this study suggest that it is feasible to use KM device to detect AF in the selected AIS patients (younger and in better neurological condition). KM detected AF in the selected AIS patients with high specificity and sensitivity.

Highlights

Thirty percent of ischemic strokes are of an unknown cause
acute ischemic stroke (AIS) patients treated at the stroke unit were recruited over a period of 12 months
Fifty patients (26 males; 24 females; mean age 64.44, SD 10.52 years) from 285 AIS patients treated at the stroke unit Department of Neurology and Epileptology met the inclusion criteria, entered the study, and used the device properly—i.e., they were able to record at least one

Summary

Introduction

Thirty percent of ischemic strokes are of an unknown cause (cryptogenic). Several mechanisms are implicated with cryptogenic stroke. 65% of patients have cortical infarcts on brain imaging, a characteristic typically suggestive of embolism [1,2]. Atrial fibrillation (AF) is the most common cardiac arrhythmia in adults, and the most common cause of cardioembolism resulting in ischemic stroke. Identifying individuals with AF in high-risk groups of patients, such as poststroke patients, could enable those patients to be treated properly [3,4]. AF diagnosis is difficult, especially in patients with paroxysmal AF and in asymptomatic (silent) AF. AF symptoms (history of palpitations, dyspnea, fatigue, chest tightness/pain, syncope/presyncope, and dizziness) could be absent during most episodes [4,5,6,7]

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