Extended 72-hour Holter-ECG monitoring in patients with acute ischemic stroke or TIA increased the detection of supraventricular tachycardia to 8.8% compared to 4.1% with 24-hour monitoring.
Observational (n=1,665)
Open-label
Yes
Does 72-hour Holter-ECG monitoring improve the detection of arrhythmias compared to 24-hour monitoring in patients with acute ischemic stroke or TIA?
Extended 72-hour Holter monitoring in post-stroke and TIA patients significantly increases the detection of various arrhythmias, including SVT and nsVT, compared to standard 24-hour monitoring.
Absolute Event Rate: 8.8% vs 4.1%
Abstract Holter-ECG monitoring is a critical component of post-stroke diagnostics, guiding cardiac work-up and secondary stroke prevention. Abnormal ECG findings beyond atrial fibrillation (AF) in stroke patients remain understudied. The prospective multicenter MonDAFIS trial randomized patients with acute ischemic stroke or transient ischemic attack (TIA) without known AF to Holter-ECG recording up to 7 days or usual care. Holter-ECG findings from the first 72 h of the intervention arm were analyzed to provide a reference guide in clinical practice. Furthermore, 24-hour and 72-hour Holter-ECG monitoring were compared to analyze the value of prolonged monitoring. 24-hour Holter-ECGs from 1,665 patients (median age 67; 40.4% women) identified supraventricular tachycardia (SVT) in 4.1% and newly-diagnosed AF in 2.2% of patients. Premature ventricular complexes were common (85.8%), ventricular couplets (28.0%) or bigeminy (14.0%) less common. Non-sustained ventricular tachycardia (nsVT) was detected in 1.7% of patients. Extended 72-hour-monitoring in 1,283 patients led to higher detection rates across all abnormalities, doubling nsVT (4.4%) and SVT (8.8%) detection rates. Generally, we observed higher detection rates with older age. Detection rates of supraventricular arrhythmias were higher in women, whereas men exhibited higher rates of ventricular abnormalities. Post-stroke ECG monitoring detects various arrhythmias beyond AF in a substantial proportion of individuals. Longer monitoring and older age are associated with increased detection rates, with notable sex-specific differences.
Thießen et al. (2026) conducted an observational in Acute ischemic stroke or transient ischemic attack (TIA) (n=1,665). 72-hour Holter-ECG monitoring vs. 24-hour Holter-ECG monitoring was evaluated on Detection of supraventricular tachycardia (SVT). Extended 72-hour Holter-ECG monitoring in patients with acute ischemic stroke or TIA increased the detection of supraventricular tachycardia to 8.8% compared to 4.1% with 24-hour monitoring.