Journal Article

DZNE-2026-00804

http://join2-wiki.gsi.de/foswiki/pub/Main/Artwork/join2_logo100x88.png Atrial fibrillation burden during in-patient cardiac monitoring after acute ischaemic stroke.

Klammer, M. G. ; Reimann, L. ; Richter, O. ; Lieschke, S. ; Stengl, H.Extern* ; Hellwig, S. ; Schoels, M. ; Nelde, A. ; Villringer, K. ; Meisel, A. ; Doehner, W. ; Nolte, C. H. ; Meisel, C. ; Endres, M.DZNE* ; Scheitz, J. F.

2026
Sage Publishing London

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Please use a persistent id in citations: doi:10.1093/esj/aakag079

Abstract: Atrial fibrillation (AF) burden, the time spent in AF, is increasingly investigated. Data on its characteristics and temporal patterns during early in-hospital telemetry after ischaemic stroke remain limited.Continuous ECG telemetry was analysed in consecutive patients with MRI-confirmed ischaemic stroke and AF admitted between October 2020 and January 2023 in this observational retrospective cohort trial. Peak AF burden within any 24-h window was categorised as low (≤1 h), medium (>1-6 h), high (> 6 h) or no recorded AF episodes. Associations with clinical and imaging features were assessed using multivariable regression.Among 392 patients with AF-related stroke (median monitoring duration 68 h, median AF burden 12.0 h), AF burden was low in 30 (7.7%), medium in 68 (17.3%), high in 193 (49.2%) and 101 (25.8%) had no recorded episodes. Left-insular stroke was negatively associated with high AF burden (aOR 0.38, 95% CI, 0.15-0.84, P < .05). There was a signal towards a positive association with right-insular stroke (aOR 1.75, 95% CI, 0.90-3.41, P = .09). The laterality difference persisted in continuous-scale analyses. First AF episodes clustered in the early evening among low-burden patients, with early morning episodes least common across all groups. Among patients with known stroke onset (n = 102), 49 exhibited AF confined to the first 48 h.AF burden varies widely during early in-hospital monitoring after ischaemic stroke and seems to differ according to insular lesion laterality. Our findings are hypothesis-generating and highlight the need for integrating lesion location, circadian and arrhythmia dynamics to characterise AF burden after stroke.

Keyword(s): Humans (MeSH) ; Atrial Fibrillation: physiopathology (MeSH) ; Atrial Fibrillation: complications (MeSH) ; Ischemic Stroke: complications (MeSH) ; Ischemic Stroke: physiopathology (MeSH) ; Female (MeSH) ; Aged (MeSH) ; Male (MeSH) ; Retrospective Studies (MeSH) ; Telemetry (MeSH) ; Electrocardiography (MeSH) ; Middle Aged (MeSH) ; Aged, 80 and over (MeSH) ; atrial fibrillation ; atrial fibrillation burden ; circadian rhythm ; continuous ; electrocardiography ; ischaemic ; stroke ; stroke-heart syndrome

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Contributing Institute(s):

1. Interdisciplinary Dementia Research (AG Endres)

Research Program(s):

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

Appears in the scientific report 2026

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Database coverage:
; ; ; Clarivate Analytics Master Journal List ; Current Contents - Clinical Medicine ; Essential Science Indicators ; IF >= 5 ; JCR ; National-Konsortium ; PubMed Central ; SCOPUS ; Science Citation Index Expanded ; Web of Science Core Collection

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