• Javier Ramos-Maqueda, Cristina Navarro-Valverde, Irene Esteve-Ruiz, Mercedes Cabrera-Ramos, Ricardo Rivera-López, Dolores García-Medina, Ricardo Pavón-Jiménez, and Francisco Javier Molano-Casimiro.
• Servicio de Cardiología, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España. Electronic address: javierramosmaqueda@secardiologia.es.
• Med Clin (Barc). 2021 Dec 24; 157 (12): 555-560.

Background And ObjectivesAtrial fibrillation (AF) detection in patients with embolic stroke of underdetermined source (ESUS) entails a change of medical treatment and a significant decrease in the incidence of new strokes. It is necessary to determine which patients would benefit more from prolonged electrocardiographic monitoring. Our aim was to find electrocardiographic and echocardiographic AF predictors in patients with ESUS.MethodsWe performed a cohort study that included 95 consecutive patients admitted to the hospital because of an ESUS. An electrocardiogram, each subject in the study underwent a 24-hour Holter-electrocardiogram (Holter-ECG) and an echocardiogram. A 2-year follow up was also conducted, with a 24-hour Holter-ECG every 3months for the first year, and every 6months during the second one.ResultsDuring the follow-up, AF was detected in 11 patients (11.6%), with a detection rate of 3.2% at 6months, 7.4% at 12months, and 11.6% at 18months as well as at 24months. The variables that were independently related to AF detection included moderate or severe left atrium dilation (P=.02), interatrial advanced block (P=.04) and more than 1000 premature atrial beats on 24-hour Holter-ECG (P=.01).ConclusionsModerate or severe atrial dilation, interatrial advanced block, and the presence of more than 1000 premature atrial beats on 24-hour Holter-ECG behave as AF predictors in patients with ESUS.Copyright © 2020 Elsevier España, S.L.U. All rights reserved.

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