Key result
Holter monitoring detects arrhythmias in ~36% of acute ischemic stroke patients, most commonly AF.
Why the study?
The frequency of cardiac arrhythmia and associated risk factors in acute ischemic stroke patients were not well characterized.
Cross-Sectional (n=115)
Yes
Prolonged cardiac monitoring with 24-hour Holter significantly improves the detection of arrhythmias, particularly atrial fibrillation, in acute ischemic stroke patients compared to standard ECG.
Background Stroke is the second leading reason for mortality, representing 11.6% of the deaths in the year 2019. Ischemic stroke represents the most common form of stroke. Aim To investigate the frequency of cardiac arrhythmia in acute ischemic stroke and define associated risk factors with acute ischemic stroke. Patient and method This cross-sectional observational study was conducted on 115 patients recruited from the Neuropsychiatry Department in Ain Shams University Hospital, 6th of October University Hospital, and the stroke unit and clinical research unit at El-Sheikh Zayed Specialized Hospital over a period of 6 months. Results The study found that most patients (70.4%) had thrombotic strokes, with common locations in temporoparietal regions (17.3%) and the basal ganglia (15.7%)). Large infarcts occurred in 40.9%, small infarcts in 37.4%, and lacunar infarctions in 27.7%. Most patients (79.1%) received medical treatment, 58.3% had wake-up strokes, and 49.6% were hospitalized for over 24 hours. An abnormal ECG was found in (20%) of patients with Atrial fibrillation recorded in (12.2%) and bradyarrhythmia was recorded in (2.6%), while a percentage of (36.2%) of patients recorded an abnormal Holter 24 h. cardiac monitoring with atrial fibrillation demonstrated in (21.7%) and bradyarrhythmia in (2.6%) and SVT in (2.6%) . A significant positive correlation was found between MRI (Magnetic Resonance Imaging) findings and the ASPECTS score (r = 0.481, P < 0.001), indicating the importance of MRI in assessing stroke severity. There was a statistically positive correlation between atrial fibrillation and age (r equal to 0.222*, P-value = 0.017). Additionally, a negative correlation was found between MRI findings and arrhythmia detected by Holter monitoring (r= -0.596, P < 0.001). Conclusion The study showed that most thrombotic stroke patients had mild to moderate severity and favorable outcomes at 90 days. It emphasized the importance of MRI findings, the aspect score, and the need for comprehensive care to improve recovery and reduce complications, the study also highlighted the most common types of cardiac arrythmia in acute ischemic stroke patients in Addition to emphasizing the importance of prolonged cardiac monitoring in detecting different types of cardiac arrythmia
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Abdelrehim et al. (2026) conducted a cross-sectional in Acute ischemic stroke (n=115). 24-hour Holter cardiac monitoring was evaluated on Abnormal 24-hour Holter cardiac monitoring for arrhythmia. Among patients with acute ischemic stroke, 24-hour Holter monitoring detected cardiac arrhythmias in 36.2%, with atrial fibrillation being the most common at 21.7%.
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