Key result
Short Holter monitoring detects atrial abnormalities in ~47% of post-stroke patients without known AF.
Why the study?
AF accounts for 20-30% of ischemic strokes and is often paroxysmal and clinically silent, limiting diagnosis on standard ECG. This study assessed the diagnostic yield of short-duration ambulatory Holter monitoring for AF detection after ischemic stroke and associated factors.
What is the diagnostic yield of 24–72-hour ambulatory Holter ECG monitoring for detecting atrial abnormalities and atrial fibrillation in patients with imaging-confirmed ischemic stroke and no prior history of AF?
Observational (n=57)
No
What is the diagnostic yield of 24–72-hour ambulatory Holter ECG monitoring for detecting atrial abnormalities and atrial fibrillation in patients with imaging-confirmed ischemic stroke and no prior history of AF?
Short-duration (24–72-hour) ambulatory Holter ECG monitoring after ischemic stroke detected atrial abnormalities in nearly half of patients and sustained AF in 3.5%, with older age and hypertension strongly associated with atrial abnormality detection.
Hypothesis-generating for short Holter AF screening post-stroke; prospective studies needed to confirm yield and impact.
Background: Atrial fibrillation (AF) accounts for 20-30% of ischemic strokes and is often paroxysmal and clinically silent, which limits its diagnosis on standard electrocardiography. Ambulatory Holter electrocardiographic (ECG) monitoring is the most accessible screening tool after ischemic stroke. This study assessed the diagnostic yield of short-duration ambulatory Holter monitoring for AF detection after ischemic stroke and identified the factors associated with detection. Methods: This retrospective, descriptive and analytical, single-center study was conducted in the Department of Cardiology, Ibn Sina University Hospital, Rabat, Morocco, from January 2025 to April 2026. Patients with imaging-confirmed ischemic stroke, no previously known AF, and a 24–72-hour ambulatory Holter ECG were included. Of 1,431 Holter recordings performed during the study period, 60 concerned stroke patients; three were excluded for insufficient data, leaving 57 patients. Age, sex, hypertension, and type 2 diabetes were recorded.
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KRIOUILE et al. (2026) conducted an observational in Ischemic stroke (n=57). Short-duration (24-72-hour) ambulatory Holter ECG monitoring was evaluated on Detection of an overall atrial abnormality (sustained AF >= 30 s, non-sustained AF < 30 s, or pure atrial hyperexcitability). Short-duration (24-72-hour) ambulatory Holter ECG monitoring detected overall atrial abnormalities in 47.4% and atrial fibrillation in 22.8% of ischemic stroke patients without prior known AF.
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