Observational studyEuropean stroke journal2026
Atrial fibrillation burden during in-patient cardiac monitoring after acute ischaemic stroke.
Observational study in European stroke journal, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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15 authors.
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Abstract
backgroundAtrial fibrillation (AF) burden, the time spent in AF, is increasingly investigated. Data on its characteristics and temporal patterns during early in-hospital telemetry after ischaemic stroke remain limited. PATIENTS AND
methodsContinuous ECG telemetry was analysed in consecutive patients with MRI-confirmed ischaemic stroke and AF admitted between October 2020 and January 2023 in this observational retrospective cohort trial. Peak AF burden within any 24-h window was categorised as low (≤1 h), medium (>1-6 h), high (> 6 h) or no recorded AF episodes. Associations with clinical and imaging features were assessed using multivariable regression.
resultsAmong 392 patients with AF-related stroke (median monitoring duration 68 h, median AF burden 12.0 h), AF burden was low in 30 (7.7%), medium in 68 (17.3%), high in 193 (49.2%) and 101 (25.8%) had no recorded episodes. Left-insular stroke was negatively associated with high AF burden (aOR 0.38, 95% CI, 0.15-0.84, P < .05). There was a signal towards a positive association with right-insular stroke (aOR 1.75, 95% CI, 0.90-3.41, P = .09). The laterality difference persisted in continuous-scale analyses. First AF episodes clustered in the early evening among low-burden patients, with early morning episodes least common across all groups. Among patients with known stroke onset (n = 102), 49 exhibited AF confined to the first 48 h.
conclusionAF burden varies widely during early in-hospital monitoring after ischaemic stroke and seems to differ according to insular lesion laterality. Our findings are hypothesis-generating and highlight the need for integrating lesion location, circadian and arrhythmia dynamics to characterise AF burden after stroke.
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