{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T16:04:31Z","timestamp":1715616271677},"reference-count":17,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2020,4,30]],"date-time":"2020-04-30T00:00:00Z","timestamp":1588204800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Euro J of Neurology"],"published-print":{"date-parts":[[2020,7]]},"abstract":"<jats:sec><jats:title>Background and purpose<\/jats:title><jats:p>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\u2010 and resource\u2010consuming manual analysis of prolonged electrocardiogram (ECG)\u2010monitoring 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)].<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>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\u2010h 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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Paroxysmal AF was finally diagnosed in 62 patients (5.9%) in the cohort (<jats:italic>n<\/jats:italic>\u00a0=\u00a01043). AA more often diagnosed pAF (<jats:italic>n<\/jats:italic>\u00a0=\u00a060, 5.8%) as compared with SA (<jats:italic>n<\/jats:italic>\u00a0=\u00a047, 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).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Automated determination of \u2018absence of pAF\u2019 could be used to reduce the manual review workload associated with review of prolonged Holter ECG recordings.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ene.14250","type":"journal-article","created":{"date-parts":[[2020,4,12]],"date-time":"2020-04-12T20:40:10Z","timestamp":1586724010000},"page":"1272-1278","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Automatic Holter electrocardiogram analysis in ischaemic stroke patients to detect paroxysmal atrial fibrillation: ready to replace physicians?"],"prefix":"10.1111","volume":"27","author":[{"given":"S.","family":"Gr\u00f6schel","sequence":"first","affiliation":[{"name":"Department of Neurology University Medical Center of the Johannes Gutenberg University Mainz Mainz Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"B.","family":"Lange","sequence":"additional","affiliation":[{"name":"Department of Cardiology II University Medical Center of the Johannes Gutenberg University Mainz Mainz Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.","family":"Grond","sequence":"additional","affiliation":[{"name":"Department of Neurology Kreisklinikum Siegen Siegen Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.","family":"Jauss","sequence":"additional","affiliation":[{"name":"Department of Neurology Hainich Klinikum M\u00fchlhausen Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P.","family":"Kirchhof","sequence":"additional","affiliation":[{"name":"Institute of Cardiovascular Sciences University of Birmingham Birmingham UK"},{"name":"Department of Cardiology SWBH and UHB NHS Trusts Birmingham UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"T.","family":"Rostock","sequence":"additional","affiliation":[{"name":"Department of Cardiology II University Medical Center of the Johannes Gutenberg University Mainz Mainz Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R.","family":"Wachter","sequence":"additional","affiliation":[{"name":"Clinic and Policlinic for Cardiology University Hospital Leipzig Leipzig Germany"},{"name":"Clinic for Cardiology and Pneumology University Medicine G\u00f6ttingen G\u00f6ttingen Germany"},{"name":"German Cardiovascular Research Center (DZHK), Partner Site G\u00f6ttingen G\u00f6ttingen Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"K.","family":"Gr\u00f6schel","sequence":"additional","affiliation":[{"name":"Department of Neurology University Medical Center of the Johannes Gutenberg University Mainz Mainz Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"T.","family":"Uphaus","sequence":"additional","affiliation":[{"name":"Department of Neurology University Medical Center of the Johannes Gutenberg University Mainz Mainz Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,4,30]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.119.026410"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000006727"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(17)30002-9"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.115.012195"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCOUTCOMES.116.002864"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-146-12-200706190-00007"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/imj.13686"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/ene.13326"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehw210"},{"key":"e_1_2_8_11_1","doi-asserted-by":"crossref","unstructured":"JanuaryCT WannLS CalkinsH FieldME ChenLY FurieKL et al.2019 AHA\/ACC\/HRS Focused Update of the 2014 AHA\/ACC\/HRS Guideline for the Management of Patients With Atrial Fibrillation: A Report of the American College of Cardiology\/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society. 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