Evidence map›Paper›PMID 28503795›Full record

ArticleEuropean journal of neurology2017

Automatic detection of paroxysmal atrial fibrillation in patients with ischaemic stroke: better than routine diagnostic workup?

T Uphaus, A Grings, S Gröschel, A Müller, M Weber-Krüger, R Wachter, K Gröschel

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In one paragraph

Article in European journal of neurology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
2.3field-weighted citation impact, top 10% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 1 synthesis or guideline pooled it, 17 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
  4. Expert opinion paper on atrial fibrillation detection after ischemic stroke.Clinical research in cardiology : official journal of the German Cardiac Society · 2018
    Review
  5. Detection of Atrial Fibrillation in Cryptogenic Stroke.Current neurology and neuroscience reports · 2018
    Review
  6. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 2 institutions in 1 country.

T UphausDepartment of Neurology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany.ORCID 0000-0001-5526-0510
A GringsDepartment of Neurology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany.
S GröschelDepartment of Neurology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany.
A MüllerDepartment of Neurology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany.
M Weber-KrügerDepartment of Cardiology and Pneumology, University of Göttingen, Göttingen, Germany.
R WachterDepartment of Cardiology and Pneumology, University of Göttingen, Göttingen, Germany.ORCID 0000-0003-2231-2200
K GröschelDepartment of Neurology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany.
Johannes Gutenberg University Mainz · DEUniversity of Göttingen · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

background and purposeProlonged electrocardiogram (ECG) monitoring after ischaemic stroke increases the diagnostic yield of paroxysmal atrial fibrillation (pAF). In order to facilitate the additional workload involved in ECG analysis due to prolonged monitoring times, we investigated the effectiveness of pAF detection with an automated software algorithm (SA) in comparison to the routine staff-based analysis (RA) during standard stroke-unit care. Therefore, patients with acute ischaemic stroke or transitory ischaemic attack presenting with sinus rhythmus on the admission ECG and no history of atrial fibrillation were prospectively included.

methodsA 24-h Holter ECG assessment was performed using either RA based on a computer-aided evaluation and subsequent review by a cardiologist or a commercially available automated SA. In the case of discordant results concerning the occurrence of pAF between the two methods, the data underwent an independent external rating.

resultsOf 809 prospectively enrolled patients, 580 patients fulfilled the inclusion criteria. pAF was ultimately diagnosed in 3.3% of the cohort (19 patients). SA and RA correctly diagnosed pAF in 17 patients resulting in a comparable diagnostic effectiveness of the analysis methods (sensitivity: SA 89.5% vs. RA 89.5%; specificity: SA 99.3% vs. RA 99.1%; κ, 0.686; P < 0.001; 95% confidence interval, 0.525-0.847). RA revealed clinically relevant ECG abnormalities in an additional seven patients.

conclusionsAlthough it should not completely replace RA, SA-based evaluation of Holter ECG reaches a high diagnostic effectiveness for the detection of pAF and can be used for a rapid and resource-saving analysis of ECG data to deal with prolonged monitoring times.

Indexed as

AgedAged, 80 and overAlgorithmsAtrial FibrillationAutomationBrain IschemiaCohort StudiesElectrocardiography, AmbulatoryFemaleHospitalizationHumansIschemic Attack, TransientMaleMiddle AgedProspective StudiesStrokecerebral infarctionHolter electrocardiogramstrokestroke unittransitory ischaemic attack

Identifiers

PMID28503795
PMCPMC5518440
OpenAlexW2616116314

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.