{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T06:05:14Z","timestamp":1785305114022,"version":"3.55.0"},"reference-count":18,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2023,1,17]]},"abstract":"\n Background<\/jats:title>\n In patients with acute ischemic stroke, little is known regarding the frequency of abnormal ECG findings other than atrial fibrillation and their association with cardiovascular outcomes. We aim to analyze the frequency and type of abnormal ECG findings, subsequent changes in medical treatment, and their association with cardiovascular outcomes in patients with acute ischemic stroke.<\/jats:p>\n <\/jats:sec>\n \n Methods and Results<\/jats:title>\n \n In the investigator\u2010initiated multicenter MonDAFIS (impact of standardized monitoring for detection of atrial fibrillation in ischemic stroke) study, 3465 patients with acute ischemic stroke or transient ischemic attack and without known atrial fibrillation were randomized 1:1 to receive Holter\u2010ECG for up to 7\u2009days in\u2010hospital with systematic evaluation in a core cardiology laboratory (intervention group) or standard diagnostic care (control group). Outcomes included predefined abnormal ECG findings (eg, pauses, atrial fibrillation, brady\u2010\/tachycardias), medical management in the intervention group, and combined vascular end point (recurrent stroke, myocardial infarction, major bleeds, or all\u2010cause death) and mortality at 24 months in both randomization groups. Predefined abnormal ECG findings were detected in 326 of 1693 (19.3%) patients in the intervention group. Twenty of these 326 patients (6.1%) received a pacemaker, and 62 of 326 (19.0%) patients had newly initiated or discontinued \u03b2\u2010blocker medication. Discontinuation of \u03b2\u2010blockers was associated with a higher death rate in the control group than in the intervention group during 24 months after enrollment (adjusted hazard ratio, 11.0 [95% CI, 2.4\u201350.4];\n P<\/jats:italic>\n =0.025 for interaction).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Systematic in\u2010hospital Holter ECG reveals abnormal findings in 1 of 5 patients with acute stroke, and mortality was lower at 24 months in patients with systematic ECG recording in the hospital. Further studies are needed to determine the potential impact of medical management of abnormal ECG findings.<\/jats:p>\n <\/jats:sec>\n \n Registration<\/jats:title>\n \n URL:\n https:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n ; Unique identifier: NCT02204267.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1161\/jaha.122.027149","type":"journal-article","created":{"date-parts":[[2023,1,11]],"date-time":"2023-01-11T10:08:42Z","timestamp":1673431722000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":13,"title":["In\u2010Hospital ECG Findings, Changes in Medical Management, and Cardiovascular Outcomes in Patients With Acute Stroke or Transient Ischemic Attack"],"prefix":"10.1161","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8153-3025","authenticated-orcid":false,"given":"Manuel C.","family":"Olma","sequence":"first","affiliation":[{"name":"Center for Stroke Research Berlin Charit\u00e9 \u2010 Universit\u00e4tsmedizin Berlin Berlin Germany"},{"name":"Berlin Institute of Health (BIH) Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Serdar","family":"T\u00fct\u00fcnc\u00fc","sequence":"additional","affiliation":[{"name":"Center for Stroke Research Berlin Charit\u00e9 \u2010 Universit\u00e4tsmedizin Berlin Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cornelia","family":"Fiessler","sequence":"additional","affiliation":[{"name":"Institute of Clinical Epidemiology and Biometry University W\u00fcrzburg W\u00fcrzburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Kunze","sequence":"additional","affiliation":[{"name":"Center for Stroke Research Berlin Charit\u00e9 \u2010 Universit\u00e4tsmedizin Berlin Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0310-5903","authenticated-orcid":false,"given":"Michael","family":"Kr\u00e4mer","sequence":"additional","affiliation":[{"name":"Center for Stroke Research Berlin Charit\u00e9 \u2010 Universit\u00e4tsmedizin Berlin Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7554-6548","authenticated-orcid":false,"given":"Lena","family":"Steindorf\u2010Sabath","sequence":"additional","affiliation":[{"name":"Center for Stroke Research Berlin Charit\u00e9 \u2010 Universit\u00e4tsmedizin Berlin Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6336-0327","authenticated-orcid":false,"given":"Muhammad","family":"Jawad\u2010Ul\u2010Qamar","sequence":"additional","affiliation":[{"name":"Institute of Cardiovascular Sciences College of Medical and Dental Sciences, Medical School University of Birmingham Birmingham United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1881-0197","authenticated-orcid":false,"given":"Paulus","family":"Kirchhof","sequence":"additional","affiliation":[{"name":"Institute of Cardiovascular Sciences College of Medical and Dental Sciences, Medical School University of Birmingham Birmingham United Kingdom"},{"name":"University Heart and Vascular Center Hamburg Hamburg Germany"},{"name":"German Center for Cardiovascular Research, Partner Site Hamburg\/Kiel\/L\u00fcbeck Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2620-9323","authenticated-orcid":false,"given":"Ulrich","family":"Laufs","sequence":"additional","affiliation":[{"name":"Department of Cardiology University Hospital, Leipzig University Leipzig Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8743-3743","authenticated-orcid":false,"given":"Johannes","family":"Schurig","sequence":"additional","affiliation":[{"name":"Center for Stroke Research Berlin Charit\u00e9 \u2010 Universit\u00e4tsmedizin Berlin Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Kraft","sequence":"additional","affiliation":[{"name":"Department of Neurology University Hospital W\u00fcrzburg W\u00fcrzburg Germany"},{"name":"Department of Neurology Hospital Main\u2010Spessart Lohr Lohr a. 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