Background

Atrial fibrillation (AF) is the most common preventable cause of stroke. Diagnosis of new AF is frequent after acute ischemic stroke (AIS). We aimed to evaluate the predictive value of the recently developed morphology-voltage-P-wave duration (MVP) ECG risk score for in-hospital and long-term AF diagnosis following AIS.

Material and methods

In this observational investigation, we evaluated the ability of the MVP ECG risk score to predict AF in 266 consecutive patients with AIS. The study population was divided into three groups according to their calculated MVP ECG risk score on admission electrocardiography. The groups were compared in terms of their predictive value for in-hospital and long-term AF diagnosis.

Results

After adjustment for confounding baseline variables, MVP ECG risk score 5–6 group had 13.2 times higher rates of in-hospital AF compared to MVP ECG risk score 0–2 group, which was used as the reference group. For long-term follow-up, MVP ECG risk score 5–6 group had 5.2 times higher rates of long-term AF compared to MVP ECG risk score 0–2 group. A ROC analysis showed that the optimal cut-off value of the MVP ECG risk score to predict in-hospital AF was 4 with 78% sensitivity and 76% specificity (AUC: 0.80; 95% CI: 0.64–0.96; p < 0.001), the optimal cut-off value of the MVP ECG risk score to predict long-term AF was 3 with 85% sensitivity and 59% specificity (AUC: 0.81; 95% CI: 0.76–0.86; p < 0.001).

Conclusion

The MVP ECG risk score, which can be easily calculated from a surface ECG, can be used to guide who needs stricter monitoring for the diagnosis of long-term AF in patients with AIS.

中文翻译：

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形态-电压-P波时长（MVP）心电图评分对预测缺血性卒中院内和远期房颤的意义

背景

心房颤动 (AF) 是中风最常见的可预防原因。急性缺血性卒中 (AIS) 后经常会诊断出新的 AF。我们旨在评估最近开发的形态-电压-P 波持续时间 (MVP) ECG 风险评分对 AIS 后住院和长期 AF 诊断的预测价值。

材料与方法

在这项观察性调查中，我们评估了 MVP ECG 风险评分预测 266 名连续 AIS 患者 AF 的能力。研究人群根据入院心电图计算的 MVP ECG 风险评分分为三组。比较各组对住院和长期 AF 诊断的预测价值。

结果

在调整混杂基线变量后，MVP ECG 风险评分 5-6 组的院内 AF 发生率是 MVP ECG 风险评分 0-2 组（用作参考组）的 13.2 倍。对于长期随访，MVP ECG 风险评分 5-6 组的长期 AF 发生率是 MVP ECG 风险评分 0-2 组的 5.2 倍。ROC 分析显示，MVP ECG 风险评分预测院内 AF 的最佳临界值为 4，敏感性为 78%，特异性为 76%（AUC：0.80；95% CI：0.64-0.96；p < 0.001） ，预测长期 AF 的 MVP ECG 风险评分的最佳截止值为 3，敏感性为 85%，特异性为 59%（AUC：0.81；95% CI：0.76-0.86；p < 0.001）。

结论

MVP 心电图风险评分可以很容易地从体表心电图计算出来，可用于指导谁需要更严格的监测来诊断 AIS 患者的长期 AF。