ABSTRACT NUMBER: ESOC2026LB187 THE INCIDENCE OF PAROXYSMAL ATRIAL FIBRILLATION IN PATIENTS WITH CRYPTOGENIC CEREBROVASCULAR ACCIDENTS

Abstract Background and aims The identification of atrial fibrillation (AF) in individuals experiencing embolic strokes constitutes a cornerstone of clinical diagnostics and management. This investigation seeks to assess the occurrence of paroxysmal atrial fibrillation (pAF) through Holter monitoring among patients diagnosed with cryptogenic cerebrovascular accidents (CVAs) within a primary healthcare framework. Methods This cohort study encompassed patients admitted to Booali Sina Hospital in Qazvin with a confirmed diagnosis of cryptogenic CVA. Participants underwent continuous electrocardiographic (EKG) monitoring for pAF during the first 48 hours of their stay in the stroke unit. Statistical evaluations comparing patients with and without pAF were conducted using SPSS version 22. Results The mean age of patients was 56.24 ± 12.63 years, with a male predominance of 59.1%. The prevalence of pAF detected via 48-hour Holter monitoring was 7.6%. Individuals exhibiting pAF were significantly older and demonstrated higher blood pressure levels, lower ejection fractions (EF), and an increased burden of comorbidities compared to those without pAF. Furthermore, patients with pAF exhibited a higher incidence of hypertension, ischemic heart disease, administration of recombinant tissue plasminogen activator (rt-PA), multifocal infarctions, multi-artery involvement, mitral stenosis, therapeutic adjustments, recurrent CVAs, and mortality (p < 0.05). Conclusions The study findings indicate a modest detection rate of 7.6% for pAF using 48-hour Holter monitoring in patients with cryptogenic CVAs. This figure is comparatively lower than rates reported in studies utilizing extended monitoring durations, suggesting that prolonged Holter surveillance may enhance diagnostic yield. Conflict of interest