• J Stroke Cerebrovasc Dis · Nov 2013

    Comparative Study

    Indecision in the clinical practice of anticoagulation for brief atrial arrhythmias after cryptogenic stroke.

    • Muhib Khan, Daniel J Miller, and Lonni R Schultz.
    • Department of Neurology, University of Massachusetts, Worcester, Massachusetts. Electronic address: muhibalamkhan@hotmail.com.
    • J Stroke Cerebrovasc Dis. 2013 Nov 1;22(8):e500-3.

    IntroductionLong-term cardiac monitoring has a substantial yield for paroxysmal atrial fibrillation (PAF) detection in cryptogenic stroke or transient ischemic attack (TIA) patients; however, many of these episodes were brief. We analyzed treatment decisions taken by the clinicians regarding anticoagulation in these short-duration PAF patients.MethodsWe performed a retrospective analysis on all mobile cardiac outpatient telemetry records between June 2009 and January 2012, initiated by neurologists from a large tertiary care institution stroke center.ResultsIn all, 39 patients were found to have atrial fibrillation (AF), and their records were reviewed. AF episodes were categorized as less than 30 seconds in 24 (62%) patients and 30 seconds or more in 15 (38%) patients. Among the 16 patients without a cardiology evaluation, the rate of anticoagulation was high and did not differ for patients with short AF (90%, 9 of 10) and long AF (83%, 5 of 6) (P>.99). However, among the 23 patients with a cardiology evaluation, the difference in rates of anticoagulation was significant between patients with short AF (43%, 6 of 14) and long AF (89%, 8 of 9) (P=.039).ConclusionOur study demonstrates the differences in anticoagulant prescribing practices between neurologists and cardiologists and the inherent indecision these findings have produced. Further study is needed to better define the risks and benefits associated with anticoagulation of brief episodes of atrial arrhythmias lasting less than 30 seconds in patients with cryptogenic stroke or TIA.Copyright © 2013 National Stroke Association. Published by Elsevier Inc. All rights reserved.

      Pubmed     Full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…