{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T01:06:39Z","timestamp":1777943199094,"version":"3.51.4"},"reference-count":27,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2020,7,8]],"date-time":"2020-07-08T00:00:00Z","timestamp":1594166400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004606","name":"Chang Gung Medical Foundation","doi-asserted-by":"publisher","award":["CORPG6D0103"],"award-info":[{"award-number":["CORPG6D0103"]}],"id":[{"id":"10.13039\/501100004606","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001409","name":"Department of Science and Technology, Ministry of Science and Technology","doi-asserted-by":"publisher","award":["MOST104-2314-B-182-019 and MOST105-2628B-182-008-M"],"award-info":[{"award-number":["MOST104-2314-B-182-019 and MOST105-2628B-182-008-M"]}],"id":[{"id":"10.13039\/501100001409","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["International Journal of Stroke"],"published-print":{"date-parts":[[2021,4]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Enhancing detection of unrecognized atrial fibrillation among acute ischemic stroke patients is crucial for secondary stroke prevention.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To evaluate whether the detection rate of new atrial fibrillation in acute ischemic stroke patients without known atrial fibrillation could be improved by doing serial 12-lead electrocardiograms once daily for five days, compared with conventional 24-h Holter monitoring (24-h Holter).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a randomized clinical trial to compare the detection rates of paroxysmal atrial fibrillation between serial electrocardiograms versus 24-h Holter from October 2015 to October 2018 at six hospitals. Eligible participants were acute ischemic stroke patients with aged \u226565 years, with neither atrial fibrillation history nor any presence of atrial fibrillation on baseline electrocardiogram at admission. The primary outcome was newly detected electrocardiogram in the serial electrocardiograms and 24-h Holter group.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 826 patients, baseline characteristics were similar between both groups. In the intention-to-treat analysis, there was no statistical difference between serial electrocardiograms versus 24-Holter to detect atrial fibrillation (8.4% vs. 6.9%; adjusted odds ratio 1.17, 95% confidence interval 0.69\u20132.01). Stepwise multivariate logistic regression revealed age \u226580 years and history of heart failure were associated with detection of paroxysmal atrial fibrillation whereas patients with lacunar infarction had lower odds for detection of paroxysmal atrial fibrillation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Serial electrocardiograms had comparable detection rate of paroxysmal atrial fibrillation compared with 24-h Holter and might be a viable alternative to 24-h Holter as a first-line approach to survey for potential paroxysmal atrial fibrillation among elderly patients with acute ischemic stroke. Clinical Trial Registration: URL https:\/\/clinicaltrials.gov\/ct2\/show\/NCT02578979 Unique Identifiers: NCT02578979<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/1747493020938297","type":"journal-article","created":{"date-parts":[[2020,7,9]],"date-time":"2020-07-09T02:45:01Z","timestamp":1594262701000},"page":"300-310","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":8,"title":["Atrial fibrillation trial to evaluate real-world procedures for their utility in helping to lower stroke events: A randomized clinical trial"],"prefix":"10.1177","volume":"16","author":[{"given":"Wen-Yi","family":"Huang","sequence":"first","affiliation":[{"name":"Department of Neurology, Chang Gung University College of Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7491-0571","authenticated-orcid":false,"given":"Meng","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Neurology, Chang Gung University College of Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sheng-Feng","family":"Sung","sequence":"additional","affiliation":[{"name":"Division of Neurology, Department of Internal Medicine, Ditmanson Medical Foundation, Chia-Yi Christian Hospital, Chiayi, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sung-Chun","family":"Tang","sequence":"additional","affiliation":[{"name":"Stroke Center and Department of Neurology, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kuo-Hsuan","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Neurology, Chang Gung University College of Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yung-Sung","family":"Huang","sequence":"additional","affiliation":[{"name":"Division of Neurology, Department of Internal Medicine, Buddhist Dalin Tzu Chi General Hospital, Chiayi, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jiann-Der","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Neurology, Chang Gung University College of Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tsong-Hai","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Neurology, Chang Gung University College of Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jiann-Shing","family":"Jeng","sequence":"additional","affiliation":[{"name":"Stroke Center and Department of Neurology, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chang-Min","family":"Chung","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine, Chang Gung University College of Medicine, Chang Gung Memorial Hospital, Chiayi Branch, Chiayi, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yi-Ling","family":"Wu","sequence":"additional","affiliation":[{"name":"Institute of Population Health Sciences, National Health Research Institutes, Miaoli County, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tsung-Ta","family":"Hsieh","sequence":"additional","affiliation":[{"name":"Department 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