Holter-ECG findings after acute ischemic stroke and TIA: A systematic analysis of the MonDAFIS randomized trial.

Premature ventricular complexes were highly prevalent in acute ischemic stroke and TIA patients on 24-hour Holter-ECG monitoring.

• 24-hour Holter-ECGs were analyzed from 1,665 patients with a median age of 67 years, 40.4% of whom were women.
• Premature ventricular complexes were detected in 85.8% of patients.
• Ventricular couplets were found in 28.0% of patients.
• Ventricular bigeminy was identified in 14.0% of patients.

Newly-diagnosed atrial fibrillation and supraventricular tachycardia were detected in a meaningful proportion of patients on 24-hour Holter-ECG.

• The study included patients with acute ischemic stroke or TIA without known atrial fibrillation.
• Newly-diagnosed AF was detected in 2.2% of patients on 24-hour monitoring.
• Supraventricular tachycardia (SVT) was identified in 4.1% of patients on 24-hour monitoring.

Non-sustained ventricular tachycardia was detected in 1.7% of patients on 24-hour Holter-ECG monitoring.

• nsVT detection was based on 24-hour recordings from 1,665 patients.
• nsVT detection rate was 1.7% at 24 hours.
• nsVT detection doubled to 4.4% with extended 72-hour monitoring.

Extending Holter-ECG monitoring from 24 hours to 72 hours substantially increased detection rates of arrhythmias across all categories.

• 72-hour monitoring was performed in 1,283 patients.
• SVT detection rate doubled from 4.1% at 24 hours to 8.8% at 72 hours.
• nsVT detection rate doubled from 1.7% at 24 hours to 4.4% at 72 hours.
• Higher detection rates with extended monitoring were observed across all ECG abnormalities examined.

Older age was associated with higher detection rates of arrhythmias on Holter-ECG monitoring after stroke or TIA.

• The association between older age and increased detection rates was observed generally across arrhythmia types.
• The median age of the study population was 67 years.
• This finding was consistent across both 24-hour and 72-hour monitoring durations.

Sex-specific differences in arrhythmia detection were observed, with women showing higher rates of supraventricular arrhythmias and men showing higher rates of ventricular abnormalities.

• 40.4% of the 1,665 patients were women.
• Detection rates of supraventricular arrhythmias were higher in women.
• Men exhibited higher rates of ventricular abnormalities.
• These sex-specific differences were characterized as 'notable' by the authors.