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@ARTICLE{Haeusler:276159,
author = {Haeusler, Karl Georg and Tütüncü, Serdar and Fiessler,
Cornelia and Jawad-Ul-Qamar, Muhammad and Kunze, Claudia and
Schurig, Johannes and Dietzel, Joanna and Krämer, Michael
and Petzold, Gabor C and Royl, Georg and Helberg, Torsten
and Thomalla, Götz and Nabavi, Darius G and Röther,
Joachim and Laufs, Ulrich and Veltkamp, Roland and
Heuschmann, Peter U and Kirchhof, Paulus and Olma, Manuel C
and Endres, Matthias},
title = {{E}xcessive {S}upraventricular {E}ctopic {A}ctivity in
{P}atients {W}ith {A}cute {I}schemic {S}troke {I}s
{A}ssociated {W}ith {A}trial {F}ibrillation {D}etection
{W}ithin 24 {M}onths {A}fter {S}troke: {A} {P}redefined
{A}nalysis of the {M}on{DAFIS} {S}tudy.},
journal = {Journal of the American Heart Association},
volume = {14},
number = {2},
issn = {2047-9980},
address = {New York, NY},
publisher = {Association},
reportid = {DZNE-2025-00231},
pages = {e034512},
year = {2025},
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.},
keywords = {Humans / Atrial Fibrillation: diagnosis / Atrial
Fibrillation: physiopathology / Atrial Fibrillation:
complications / Female / Male / Aged / Ischemic Stroke:
diagnosis / Ischemic Stroke: mortality / Ischemic Stroke:
physiopathology / Ischemic Stroke: etiology /
Electrocardiography, Ambulatory: methods / Prospective
Studies / Time Factors / Middle Aged / Atrial Premature
Complexes: diagnosis / Atrial Premature Complexes:
physiopathology / Recurrence / Risk Factors / Aged, 80 and
over / ECG (Other) / atrial fibrillation (Other) / atrial
run (Other) / death (Other) / stroke (Other) /
supraventricular ectopy (Other)},
cin = {AG Endres / AG Petzold / Patient Studies (Bonn)},
ddc = {610},
cid = {I:(DE-2719)1811005 / I:(DE-2719)1013020 /
I:(DE-2719)1011101},
pnm = {353 - Clinical and Health Care Research (POF4-353)},
pid = {G:(DE-HGF)POF4-353},
typ = {PUB:(DE-HGF)16},
pubmed = {pmid:39791425},
doi = {10.1161/JAHA.123.034512},
url = {https://pub.dzne.de/record/276159},
}