Evidence map›Paper›PMID 40051669›Full record

ArticleCardiology research2025

Computer-Assisted Electrocardiogram Analysis Improves Risk Assessment of Underlying Atrial Fibrillation in Cryptogenic Stroke.

Dafne Viliani, Alberto Cecconi, Miguel Angel Spinola Tena, Alberto Vera, Alvaro Ximenez-Carrillo, Carmen Ramos, Pablo Martinez-Vives, Beatriz Lopez-Melgar, Alvaro Montes Muniz, Clara Aguirre and 4 more

Abstract read
In one paragraph

Article in Cardiology research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–field-weighted citation impact
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

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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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

14 authors.

Dafne VilianiCardiology Department, Ospedale Santa Chiara, Trento, Italy.
Alberto CecconiCardiology Department, Hospital Universitario de La Princesa, Universidad Autonoma de Madrid, Madrid, Spain.
Miguel Angel Spinola TenaData Analysis Unit, Instituto de Investigacion Sanitaria, Hospital Universitario de la Princesa, Madrid, Spain.
Alberto VeraCardiology Department, Hospital Universitario de La Princesa, Universidad Autonoma de Madrid, Madrid, Spain.
Alvaro Ximenez-CarrilloStroke Center, Neurology Department, Hospital Universitario de La Princesa, Universidad Autonoma de Madrid, IIS-IP, Madrid, Spain.
Carmen RamosStroke Center, Neurology Department, Hospital Universitario de La Princesa, Universidad Autonoma de Madrid, IIS-IP, Madrid, Spain.
Pablo Martinez-VivesCardiology Department, Hospital Universitario de La Princesa, Universidad Autonoma de Madrid, Madrid, Spain.
Beatriz Lopez-MelgarCardiology Department, Hospital Universitario de La Princesa, Universidad Autonoma de Madrid, Madrid, Spain.
Alvaro Montes MunizCardiology Department, Hospital Universitario de La Princesa, Universidad Autonoma de Madrid, Madrid, Spain.
Clara AguirreStroke Center, Neurology Department, Hospital Universitario de La Princesa, Universidad Autonoma de Madrid, IIS-IP, Madrid, Spain.
Jose VivancosStroke Center, Neurology Department, Hospital Universitario de La Princesa, Universidad Autonoma de Madrid, IIS-IP, Madrid, Spain.
Guillermo OrtegaData Analysis Unit, Instituto de Investigacion Sanitaria, Hospital Universitario de la Princesa, Madrid, Spain.
Fernando AlfonsoCardiology Department, Hospital Universitario de La Princesa, Universidad Autonoma de Madrid, Madrid, Spain.
Luis Jesus Jimenez-BorregueroCardiology Department, Hospital Universitario de La Princesa, Universidad Autonoma de Madrid, Madrid, Spain.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: The detection of underlying paroxysmal atrial fibrillation (AF) in patients with cryptogenic stroke (CS) can be challenging, and there is great interest in finding predictors of its hidden presence. The recent development of sophisticated software has enhanced the diagnostic and prognostic performance of the 12-lead electrocardiogram (ECG). Our aim was to assess the additional role of a computer-assisted ECG analysis in identifying predictors of AF in patients with CS. Methods: Sixty-seven patients with ischemic stroke or high-risk transient ischemic attack of unknown etiology were prospectively studied. Their 12-lead digitized ECG was analyzed with dedicated software, quantifying 468 morphological variables. The main clinical, biochemical, and echocardiographic variables were also collected. At discharge, patients were monitored with a wearable Holter for 15 days, and the primary outcome was the detection of AF. Results: The median age was 80 (interquartile range (IQR): 73 - 84) and AF was detected in 21 patients (31.3%). After preselecting significant ECG variables from the univariate analysis, a multivariate regression including other significant clinical, biochemical and echocardiographic predictors of AF was performed. Among the automatically analyzed ECG parameters, the amplitude of the R wave in V1 (V1_ramp) was significantly associated with the outcome. The best model to predict AF was composed of age, N-terminal B-type natriuretic peptide (NT-proBNP), left atrial reservoir strain (LASr) and V1_ramp. This model showed good discrimination capacity (corrected Somer's D Conclusions: The addition of computer-assisted ECG analysis can help stratify the risk of AF in the challenging clinical setting of CS.

Indexed as

Computer-assisted ECG analysisCryptogenic strokeParoxysmal atrial fibrillation

Identifiers

PMID40051669
PMCPMC11882229

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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.