Gutenberg Open Science: Automatic Holter electrocardiogram analysis in ischaemic stroke patients to detect paroxysmal atrial fibrillation : ready to replace physicians?

Please use this identifier to cite or link to this item: http://doi.org/10.25358/openscience-6286

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DC Field	Value	Language
dc.contributor.author	Gröschel, Sonja	-
dc.contributor.author	Lange, Björn	-
dc.contributor.author	Grond, Martin	-
dc.contributor.author	Jauss, Jan Marek	-
dc.contributor.author	Kirchhof, Paulus	-
dc.contributor.author	Rostock, Thomas	-
dc.contributor.author	Wachter, Rolf	-
dc.contributor.author	Gröschel, Klaus	-
dc.contributor.author	Uphaus, Timo	-
dc.date.accessioned	2021-08-16T09:40:01Z	-
dc.date.available	2021-08-16T09:40:01Z	-
dc.date.issued	2020	-
dc.identifier.uri	https://openscience.ub.uni-mainz.de/handle/20.500.12030/6296	-
dc.description.abstract	BACKGROUND AND PURPOSE The detection of paroxysmal atrial fibrillation (pAF) in patients presenting with ischaemic stroke shifts secondary stroke prevention to oral anticoagulation. In order to deal with the time- and resource-consuming manual analysis of prolonged electrocardiogram (ECG)-monitoring data, we investigated the effectiveness of pAF detection with an automated algorithm (AA) in comparison to a manual analysis with software support within the IDEAS study [study analysis (SA)]. METHODS We used the dataset of the prospective IDEAS cohort of patients with acute ischaemic stroke/transient ischaemic attack presenting in sinus rhythm undergoing prolonged 72-h Holter ECG with central adjudication of atrial fibrillation (AF). This adjudicated diagnosis of AF was compared with a commercially available AA. Discordant results with respect to the diagnosis of pAF were resolved by an additional cardiological reference confirmation. RESULTS Paroxysmal AF was finally diagnosed in 62 patients (5.9%) in the cohort (n = 1043). AA more often diagnosed pAF (n = 60, 5.8%) as compared with SA (n = 47, 4.5%). Due to a high sensitivity (96.8%) and negative predictive value (99.8%), AA was able to identify patients without pAF, whereas abnormal findings in AA required manual review (specificity 96%; positive predictive value 60.6%). SA exhibited a lower sensitivity (75.8%) and negative predictive value (98.5%), and showed a specificity and positive predictive value of 100%. Agreement between the two methods classified by kappa coefficient was moderate (0.591). CONCLUSION Automated determination of ‘absence of pAF’ could be used to reduce the manual review workload associated with review of prolonged Holter ECG recordings.	en_GB
dc.language.iso	eng	de
dc.rights	CC BY-NC-ND	*
dc.rights.uri	https://creativecommons.org/licenses/by-nc-nd/4.0/	*
dc.subject.ddc	610 Medizin	de_DE
dc.subject.ddc	610 Medical sciences	en_GB
dc.title	Automatic Holter electrocardiogram analysis in ischaemic stroke patients to detect paroxysmal atrial fibrillation : ready to replace physicians?	en_GB
dc.type	Zeitschriftenaufsatz	de
dc.identifier.doi	http://doi.org/10.25358/openscience-6286	-
jgu.type.dinitype	article	en_GB
jgu.type.version	Published version	de
jgu.type.resource	Text	de
jgu.organisation.department	FB 04 Medizin	de
jgu.organisation.number	2700	-
jgu.organisation.name	Johannes Gutenberg-Universität Mainz	-
jgu.rights.accessrights	openAccess	-
jgu.journal.title	European journal of neurology	de
jgu.journal.volume	27	de
jgu.journal.issue	7	de
jgu.pages.start	1272	de
jgu.pages.end	1278	de
jgu.publisher.year	2020	-
jgu.publisher.name	Wiley-Blackwell	de
jgu.publisher.place	Oxford u.a.	de
jgu.publisher.uri	https://doi.org/10.1111/ene.14250	de
jgu.publisher.issn	1468-1331	de
jgu.organisation.place	Mainz	-
jgu.subject.ddccode	610	de
jgu.publisher.doi	10.1111/ene.14250
jgu.organisation.ror	https://ror.org/023b0x485
Appears in collections:	JGU-Publikationen

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