{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,3]],"date-time":"2026-02-03T21:25:24Z","timestamp":1770153924611,"version":"3.49.0"},"reference-count":50,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2019,11,16]],"date-time":"2019-11-16T00:00:00Z","timestamp":1573862400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Occult paroxysmal atrial fibrillation (PAF) is a common and potential treatable cause of cryptogenic stroke (CS). We sought to prospectively identify independent predictors of atrial fibrillation (AF) detection in patients with CS and sinus rhythm on baseline electrocardiogram (ECG), without prior AF history. We had hypothesized that cardiac arrhythmia detection during neurosonology examinations (Carotid Duplex (CDU) and Transcranial Doppler (TCD)) may be associated with higher likelihood of AF detection. Methods: Consecutive CS patients were prospectively evaluated over a six-year period. Demographics, clinical and imaging characteristics of cerebral ischemia were documented. The presence of arrhythmia during spectral waveform analysis of CDU\/TCD was recorded. Left atrial enlargement was documented during echocardiography using standard definitions. The outcome event of interest included PAF detection on outpatient 24-h Holter ECG recordings. Statistical analyses were performed using univariate and multivariate logistic regression models. Results: A total of 373 patients with CS were evaluated (mean age 60 \u00b1 11 years, 67% men, median NIHSS-score 4 points). The rate of PAF detection of any duration on Holter ECG recordings was 11% (95% CI 8%\u201314%). The following three variables were independently associated with the likelihood of AF detection on 24-h Holter-ECG recordings in both multivariate analyses adjusting for potential confounders: age (OR per 10-year increase: 1.68; 95% CI: 1.19\u20132.37; p = 0.003), moderate or severe left atrial enlargement (OR: 4.81; 95% CI: 1.77\u201313.03; p = 0.002) and arrhythmia detection during neurosonology evaluations (OR: 3.09; 95% CI: 1.47\u20136.48; p = 0.003). Conclusion: Our findings underline the potential utility of neurosonology in improving the detection rate of PAF in patients with CS.<\/jats:p>","DOI":"10.3390\/jcm8112002","type":"journal-article","created":{"date-parts":[[2019,11,18]],"date-time":"2019-11-18T04:31:10Z","timestamp":1574051470000},"page":"2002","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Potential Utility of Neurosonology in Paroxysmal Atrial Fibrillation Detection in Patients with Cryptogenic Stroke"],"prefix":"10.3390","volume":"8","author":[{"given":"Chrissoula","family":"Liantinioti","sequence":"first","affiliation":[{"name":"Second Department of Neurology, \u201cAttikon\u201d University Hospital, School of Medicine, National and Kapodistrian University of Athens, 12462 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lina","family":"Palaiodimou","sequence":"additional","affiliation":[{"name":"Second Department of Neurology, \u201cAttikon\u201d University Hospital, School of Medicine, National and Kapodistrian University of Athens, 12462 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Konstantinos","family":"Tympas","sequence":"additional","affiliation":[{"name":"Second Department of Cardiology, \u201cAttikon\u201d University Hospital, Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"Parissis","sequence":"additional","affiliation":[{"name":"Second Department of Cardiology, \u201cAttikon\u201d University Hospital, Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7229-2610","authenticated-orcid":false,"given":"Aikaterini","family":"Theodorou","sequence":"additional","affiliation":[{"name":"Second Department of Neurology, \u201cAttikon\u201d University Hospital, School of Medicine, National and Kapodistrian University of Athens, 12462 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8241-7886","authenticated-orcid":false,"given":"Ignatios","family":"Ikonomidis","sequence":"additional","affiliation":[{"name":"Second Department of Cardiology, \u201cAttikon\u201d University Hospital, Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria","family":"Chondrogianni","sequence":"additional","affiliation":[{"name":"Second Department of Neurology, \u201cAttikon\u201d University Hospital, School of Medicine, National and Kapodistrian University of Athens, 12462 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christina","family":"Zompola","sequence":"additional","affiliation":[{"name":"Second Department of Neurology, \u201cAttikon\u201d University Hospital, School of Medicine, National and Kapodistrian University of Athens, 12462 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sokratis","family":"Triantafyllou","sequence":"additional","affiliation":[{"name":"Second Department of Neurology, \u201cAttikon\u201d University Hospital, School of Medicine, National and Kapodistrian University of Athens, 12462 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andromachi","family":"Roussopoulou","sequence":"additional","affiliation":[{"name":"Second Department of Neurology, \u201cAttikon\u201d University Hospital, School of Medicine, National and Kapodistrian University of Athens, 12462 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8317-6428","authenticated-orcid":false,"given":"Odysseas","family":"Kargiotis","sequence":"additional","affiliation":[{"name":"Stroke Unit, Metropolitan Hospital, 18547 Piraeus, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aspasia","family":"Serdari","sequence":"additional","affiliation":[{"name":"Department of Neurology, University Hospital of Alexandroupolis, Democritus University of Thrace, School of Medicine, 68100 Alexandroupolis, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anastasios","family":"Bonakis","sequence":"additional","affiliation":[{"name":"Second Department of Neurology, \u201cAttikon\u201d University Hospital, School of Medicine, National and Kapodistrian University of Athens, 12462 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Konstantinos","family":"Vadikolias","sequence":"additional","affiliation":[{"name":"Department of Neurology, University Hospital of Alexandroupolis, Democritus University of Thrace, School of Medicine, 68100 Alexandroupolis, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Konstantinos","family":"Voumvourakis","sequence":"additional","affiliation":[{"name":"Second Department of Neurology, \u201cAttikon\u201d University Hospital, School of Medicine, National and Kapodistrian University of Athens, 12462 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leonidas","family":"Stefanis","sequence":"additional","affiliation":[{"name":"Second Department of Neurology, \u201cAttikon\u201d University Hospital, School of Medicine, National and Kapodistrian University of Athens, 12462 Athens, Greece"},{"name":"First Department of Neurology, Eginition Hospital, National and Kapodistrian University of Athens, School of Medicine, 11528 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gerasimos","family":"Filippatos","sequence":"additional","affiliation":[{"name":"Second Department of Cardiology, \u201cAttikon\u201d University Hospital, Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Georgios","family":"Tsivgoulis","sequence":"additional","affiliation":[{"name":"Second Department of Neurology, \u201cAttikon\u201d University Hospital, School of Medicine, National and Kapodistrian University of Athens, 12462 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2019,11,16]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2050","DOI":"10.1161\/01.STR.0000079818.08343.8C","article-title":"Differences in vascular risk factors between etiological subtypes of ischemic stroke: Importance of population based studies","volume":"34","author":"Schulz","year":"2003","journal-title":"Stroke"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"288","DOI":"10.1161\/STROKEAHA.117.019524","article-title":"Stroke incidence and outcomes in 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