심방세동 발견에 있어 뇌졸중 치료실의 유용성

Abstract

Background: Detection of atrial fibrillation (AF), either permanent or paroxysmal, is important in stroke patients because its presence requires life-long anticoagulation for prevention of recurrent stroke. The aim of this study was to investigate the effect of continuous electrocardiography (ECG) monitoring in the stroke unit (SU) for the detection of AF. Methods: Subjects enrolled for this study were the patients who had admitted due to acute ischemic stroke before and after operation of the SU. All patients were monitored by continuous ECG during their stay in the SU. The frequency of AF, which were documented at admission and detected during their hospitalization, was compared in them. Results: Total 937 patients had admitted to the general ward (GW) before the SU opened and 1605 patients to the GW or SU after the SU opened. Among patients admitted after the SU opened, 1074 patients (66.9%) were stayed in the SU during their hospitalization (mean 4.4 days). AF was found in 144 patients (15.4%) among those admitted before the SU opened and in 281 (17.5%) among those admitted after the SU. The frequency of AF documented at admission was not different between the groups (14.4% in the before SU, 15.1% in the after SU, <0.05). The frequency of newly detected AF (3.8%) among patients who admitted to the SU was significantly higher than those admitted to the GW before (1.1%) or after the SU opened (0.6%)(P<0.001). Conclusion: The detection rate of AF in acute ischemic stroke patients has been increased significantly by continuous ECG monitoring in the SU.