Journal Article

DZNE-2025-00231

http://join2-wiki.gsi.de/foswiki/pub/Main/Artwork/join2_logo100x88.png Excessive Supraventricular Ectopic Activity in Patients With Acute Ischemic Stroke Is Associated With Atrial Fibrillation Detection Within 24 Months After Stroke: A Predefined Analysis of the MonDAFIS Study.

Haeusler, K. G. ; Tütüncü, S. ; Fiessler, C. ; Jawad-Ul-Qamar, M. ; Kunze, C. ; Schurig, J. ; Dietzel, J. ; Krämer, M. ; Petzold, G. C.DZNE* ; Royl, G. ; Helberg, T. ; Thomalla, G. ; Nabavi, D. G. ; Röther, J. ; Laufs, U. ; Veltkamp, R. ; Heuschmann, P. U. ; Kirchhof, P. ; Olma, M. C. ; Endres, M. (Last author)DZNE*

2025
Association New York, NY

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Please use a persistent id in citations: doi:10.1161/JAHA.123.034512

Abstract: Excessive supraventricular ectopic activity (ESVEA) is regarded as a risk marker for later atrial fibrillation (AF) detection.The investigator-initiated, prospective, open, multicenter MonDAFIS (Impact of Standardized Monitoring for Detection of Atrial Fibrillation in Ischemic Stroke) study randomized 3465 patients with acute ischemic stroke without known AF 1:1 to usual diagnostic procedures for AF detection or additive Holter monitoring in hospital for up to 7 days, analyzed in a core laboratory. Secondary study objectives include the comparison of recurrent stroke, myocardial infarction, major bleeding, and all-cause death within 24 months in patients with ESVEA (defined as ectopic supraventricular beats ≥480/day or atrial runs of 10-29 seconds or both) versus patients with newly diagnosed AF versus patients without ESVEA or AF (non-ESVEA/AF), randomized to the intervention group. Overall, 1435 (84.8%) of 1714 patients randomized to the intervention group had analyzable study ECG monitoring of at least 48 hours' duration within the first 72 hours of monitoring. ESVEA was detected in 363 (25.3%) patients, while AF was first detected in 48 (3.3%) patients. Within 24 months, AF was newly detected in 67 (18.5%) patients with ESVEA versus 60 (5.9%) patients without ESVEA/AF- (P<0.001). The composite outcome at 24 months was not different between patients with ESVEA and patients without ESVEA/AF (15.2% versus 12.6%; P=0.242). All-cause death was numerically higher in patients with ESVEA (6.6% versus 3.2%), but failed statistical significance (P=0.433) in multivariate analysis (including age, heart failure, stroke severity, and creatinine at baseline).ESVEA in the acute phase of ischemic stroke or transient ischemic attack is associated with AF detection during follow-up and therefore may be used to select patients for prolonged ECG monitoring.URL: https://www.clinicaltrials.gov; Unique identifier: NCT02204267.

Keyword(s): Humans (MeSH) ; Atrial Fibrillation: diagnosis (MeSH) ; Atrial Fibrillation: physiopathology (MeSH) ; Atrial Fibrillation: complications (MeSH) ; Female (MeSH) ; Male (MeSH) ; Aged (MeSH) ; Ischemic Stroke: diagnosis (MeSH) ; Ischemic Stroke: mortality (MeSH) ; Ischemic Stroke: physiopathology (MeSH) ; Ischemic Stroke: etiology (MeSH) ; Electrocardiography, Ambulatory: methods (MeSH) ; Prospective Studies (MeSH) ; Time Factors (MeSH) ; Middle Aged (MeSH) ; Atrial Premature Complexes: diagnosis (MeSH) ; Atrial Premature Complexes: physiopathology (MeSH) ; Recurrence (MeSH) ; Risk Factors (MeSH) ; Aged, 80 and over (MeSH) ; ECG ; atrial fibrillation ; atrial run ; death ; stroke ; supraventricular ectopy

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Contributing Institute(s):

1. Interdisciplinary Dementia Research (AG Endres)
2. Vascular Neurology (AG Petzold)
3. Patient Studies (Bonn) (Patient Studies (Bonn))

Research Program(s):

1. 353 - Clinical and Health Care Research (POF4-353) (POF4-353)

Appears in the scientific report 2025

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Database coverage:
; ; ; ; Article Processing Charges ; Clarivate Analytics Master Journal List ; DEAL Wiley ; DOAJ Seal ; Essential Science Indicators ; Fees ; IF >= 5 ; JCR ; SCOPUS ; Science Citation Index Expanded ; Web of Science Core Collection

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