Seventy-two hours holter ECG monitoring in patients with ischemic stroke in tertiary centre

Abstract

Background: Holter electrocardiogram (ECG) monitoring can detect atrial fibrillation (AF) in patients with stroke who are admitted with normal routine ECG. We studied AF, its predictors and risk factors in patients with acute ischemic stroke using 72 hours holter ECG monitoring. 

Materials and methods: This was a cross–sectional study conducted in 51 patients with acute ischemic stroke with normal routine ECG admitted within 24 hour of stroke onset. Their clinical profile and laboratory parameters were meticulously recorded. Holter ECG monitor was connected for 72 hours and presence of AF was monitored. During monitoring, all the participants received standard treatment 
for stroke. The presence of AF in the 72 hours holter monitoring was noted. All the variables were subjected for bivariate analysis (P<0.25) and the significant variables obtained were further subjected to multivariate logistic regression analysis (P<0.10) to identify the predictors of AF. 

Results: The mean age of the participants was 66.80 years. Major risk factors were hypertension (62.7%), smoking (58.8%) and diabetes (45.1%). The median National Institute of Health Stroke Scale (NIHSS) on admission of patients with AF was 23.50 (score 0–42; higher number indicating higher severity) and those without AF was 18.00. Among 51 patients, holter monitor detected AF in 12 (23.5%) patients.

Conclusion: In our study, hypertension, smoking and diabetes were identified as major risk factors for ischemic stroke. Almost a quarter of ischemic stroke patients had atrial fibrillation on 72–hour holter electrocardiogram monitoring and National Institute of Health Stroke Scale on admission was found to be an important predictor of AF.