48 hours Holter monitoring in detecting occult atrial fibrillation in young patients with possible cardioembolic stroke

Abstract

Background and objective: Atrial fibrillation (AF) is a common cause of ischemic stroke. AF is usually paroxysmal and could escape detection via single lead electrocardiogram ECG recorder. Holter monitoring is useful in this scenario. The objective of this study was to assess the role of 48 hours Holter monitoring in identifying clinically inapparent AF in young patients with ischemic stroke  Methods: A retrospective cross-sectional study was conducted with patient data from November 2019 to February 2021. It was conducted in Neurology department of Pakistan Institute of Medical Sciences, Islamabad, Pakistan. Study contained medical records of 60 patients which were admitted in this time period. Forty-eight hours Holter monitoring was carried out for all the patients. Patient medical records were examined according to predetermined risk factors and criteria. Statistical analysis was done on SPSS version 25.0. Results: Ten out of 60 cases had positive results for AF during Holter’s monitoring. Fifty cases had negative results for AF during Holter monitoring.  While the p value of the data obtained remained non-significant, results depict efficacy of Holter’s monitoring in detection of AF to some extent. Conclusion: Holter monitoring can identify AF, providing aid in prevention of secondary ischemic stroke. However, instead of 48 hours monitoring, a through 72 hours or extended monitoring will increase the effectiveness of this monitoring. In future, a study could be conducted where a large number of cases should be included so that statistical significance of data could be increased.