P461 ECG MONITORING TO DETECT ATRIAL FIBRILLATION IN PATIENT WITH CRYPTOGENIC ISCHEMIC STROKE

Abstract

Abstract Backgroound It’s Known that atrial fibrillation ( AF) is related to 20 % of ischemic stroke, but it is also found in one third of cryptogenetic, lacunar, atherotrombotic stroke. After stroke cardiac test are reccomended . 24 h holter ECG has a diagnostic yield about 1 – 5 % .Nowadays exists diagnostic test for ECG monitoring with a major diagnostic yield, but they are reccomended only in selected stroke patients Methods We considered consecutively 256 pazienti hospitalized in Neurology Division with ischemic stroke or transient ischemic attack ( TIA) from February to December 2022 recepient of 24 h or 72 h Holter ECG executed in Cardiology division. We evaluated AF registration, < 30 sec atrial tachicardia ( TA) and cerebral lesions. Results Out of 256 patients, with average 77±19 anni years, 149 ( 58%)were males and 105 ( 42%) females with average CHA2DS2VAS 4. AF was detected from 24 – 72 h Holter ECG 24 h – 72 in 11 patients ( 3,9%)with average age 84 years and CHA2DS2VASC 5 . The effective diagnotic yield was 3,1%. Considering cerebral injury imaging of acute stroke iun patients with AF, 3 patient had cortical injury ( one of these with early Hemorragic infarction), 2 con lesioni cortico– subcortical lesions, 2 lacunar lesions e 3 without lesions. We found < 30 seconds atrial tachicardia in 20 patients ( 8%) with average age 80 years e CHA2Ds2VAS 5 Cerebral lesions of these patients were : 5 lacunar lesions, 5 cortical lesion in multiple region, 3 cortico subcortical, 1 corticali, 2 lesions from atherotrombotic etiology, 4 without lesions Conclusions In out experience we confirm a 24 – 72 h Holter ECG low diagnostic yield to AF diagnosis more frequent in older patients with high CHA2DSAVSC score. Porolonged ECG monitoring can be considered in parients with cortico subcortical or cortical in multiple territories and with < 30 seconds AT detected at 24 – 72 holter ECG .