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22. European Stroke Conference 4 Heart and brain 9:00 - 9:10 Echocardiography in patients with cryptogenic stroke: Can paroxystic Atrial Fibrillation be predicted? Results from the SURPRISE study. L.M. Christensen1, T. Biering-Sørensen2, D. W. Krieger3, S. Højberg4, M. D. Jacobsen5, F. M. Karlsen6, K. Ægidius7, S. Rosenbaum8, J. Marstrand9, R. Møgelvang10, J. S. Jensen11, H. Niel-sen12, L. Leth-Jeppesen13, H. K. Christensen14 University Hospital Bispebjerg, Dept. of Neurology, Copenhagen, DENMARK1,University Hospital Gentofte, Dept. of Cardiology, Copenhagen, DENMARK2, University Hospital Bis-pebjerg, Dept. of Neurology, Copenhagen, DENMARK3, University Hospital Bispebjerg, Dept. of Cardiology, Copenhagen, DENMARK4, University Hospital Bispebjerg, Dept of Cardiology, Copenhagen, DENMARK5, University Hospital Bispebjerg, Dept. of Cardiology, Copenhagen, DENMARK6, University Hospital Bispebjerg, Dept. of Neurology, Copenhagen, DENMARK7, University Hospital Bispebjerg, Dept. of Neurology, Copenhagen, DENMARK8, University Hospital Bispebjerg, Dept. of Neurology, Copenhagen, DENMARK9, University Hospital Gentofte, Dept. of Cardiology, Copenhagen, DENMARK10, Universi-ty Hospital Gentofte, Dept. of Cardiology, Copenhagen, DENMARK11, University Hospital Bispebjerg, Dept. of Neurology, Copenhagen, DENMARK12, University Hospital Bispebjerg, Dept. of Neurology, Copenhagen, DENMARK13, University Hospital Bispebjerg, Dept. of Neu-rology, Copenhagen, DENMARK14 Background The SURPRISE study investigated the amount of paroxysmal atrial fibrillation (PAF) in pa-tients with cryptogenic stroke or TIA by long-term monitoring with Reveal XT®. Previous reports suggest a significant relationship between the diameter of the left atrium and the preva-lence of atrial fibrillation. Method Echocardiography was done as a transthoragic TTE, transoesopharyngeal TEE or both – if TTE was conclusive or if the patient requested it, TEE was omitted. Imaging analyzed by a blinded investigator. Left atrial diameter, Left Ventricular Ejection Fraction (LVEF) and the presence of persistent foramen ovale (PFO) were included in the analysis. Data including patient character-istics, risk factor profile, lab results, cerebral imaging and monitoring results were recorded in all patients. No patients were diagnosed with left atrial dysfunction pre stroke. Results Of the 87 patients included in the study, 19.5% (17) were found to have PAF during the course of the study. Mean left atrium diameter was 4.1 cm in the AF group vs 3.7 cm in the non AF group (p=0.014). LVEF was 50.4 % vs 51.8 % in the non AF group, n.s. PFO was found in 18.3 %, 7.1 % in the AF group vs. 21.6% in the non AF group, n.s. Conclusion Left atrium diameter was larger in patients later to have documented PAF, this may reflect the pathophysiology of AF. No significant differences were observed in LVEF and PFO. 3 Heart and brain 8:50 - 9:00 Paroxystic Atrial Fibrillation (PAF) in Patients with minor ischaemic stroke or transient iscaemic attack. Final Results from the SURPRISE Project on Long-term Monitoring. L. M. Christensen1, D. W. Krieger2, S. Højberg3, F. M. Karlsen4, M. D. Jacobsen5, T. Bier-ing- Sørensen6, R. H. Worch7, K. Ægidius8, L. L. Jeppesen9, L. Willer10, S. Rosenbaum11, J. Marstrand12, H. K. Christensen13 Bispebjerg Hospital, University Hospital of Copenhagen, Dept. of Neurology, Copenha-gen, DENMARK1,University Hospital Bispebjerg, Dept. of Neurology, Copenhagen, DEN-MARK2, University Hospital Bispebjerg, Dept. of Cardiology, Copenhagen, DENMARK3, University Hospital Bispebjerg, Dept. of Cardiology, Copenhagen, DENMARK4, University Hospital Bispebjerg, Dept. of Cardiology, Copenhagen, DENMARK5, University Hospital Gentofte, Dept. of Cardiology, Gentofte, DENMARK6, University Hospital Gentofte, Dept. of Cardiology, Gentofte, DENMARK7, University Hospital Bispebjerg, Dept. of Neurology, Copenhagen, DENMARK8, University Hospital Bispebjerg, Dept. of Neurology, Copenhagen, DENMARK9, University Hospital Bispebjerg, Dept. of Neurology, Copenhagen, DENMARK10, Universi-ty Hospital Bispebjerg, Dept. of Neurology, Copenhagen, DENMARK11, University Hospital Bispebjerg, Dept. of Neurology, Copenhagen, DENMARK12, University Hospital Bispebjerg, Dept. of Neurology, Copenhagen, DENMARK13 Background The true frequency of AF in patients with cryptogenic stroke or TIA is not well defined. Aim of study was to estimate frequency and burden of AF in patients with cryptogenic minor stroke or TIA by long term monitoring providing complete data on arrhythmia occurrence. Methods Patients with minor stroke or DWI-positive TIA were included if stroke mechanism remained unknown after standardized work up including 24 hour telemetry. A Reveal XT®, an atrial fibrillation sensitive loop-recorder, was implanted subcutaneously allowing continuous moni-toring for up to 3 years. Arrhythmia episodes were adjudicated by senior consultant cardiolo-gist. Endpoints include episodes of AF, time of AF and burden of AF. A total of 85 patients were implanted and had a minimum of six months of monitoring before final analysis. Five patients were explanted prematurely due to local infection or discomfort. Results In 14 patients (16.5 %) AF was documented by long term monitoring. All patients were subse-quently anti-coagulated. The burden of events was defined by duration of events. AF patients had a mean of 25 events lasting between 1 and 4 hours (total 328 events, median 7). Events of 10 minutes to one hour of AF occurred with a mean frequency of 217, events lasting 2 to 10 minutes occurred 932 times in mean. Average total monitoring time was 1,5 years. The mean time from stroke onset to first recorded event of AF was 97 days (median 98 days) Time from stroke onset to implantation was at median 63 days, mean 87 days. Conclusion Paroxysmal AF is frequent and brief in patients with cryptogenic stroke. The first detected events occurred rather late but with a substantial burden. Long term monitoring resulted in change of treatment in one out of 6 patients in this cohort. As anticoagulant treatment improves prognosis in patients with AF after stroke, better identification of AF is likely to reduce the bur-den of recurrent stroke. 22 © 2013 S. Karger AG, Basel Scientific Programme


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