ROLE OF AMBULATORY HOLTER ELECTROCARDIOGRAPHIC MONITORING IN DETECTING ATRIAL FIBRILLATION IN PATIENTS WITH ISCHEMIC STROKE

Abstract

Background: Atrial fibrillation (AF) accounts for 20-30% of ischemic strokes and is often paroxysmal and clinically silent, which limits its diagnosis on standard electrocardiography. Ambulatory Holter electrocardiographic (ECG) monitoring is the most accessible screening tool after ischemic stroke. This study assessed the diagnostic yield of short-duration ambulatory Holter monitoring for AF detection after ischemic stroke and identified the factors associated with detection. Methods: This retrospective, descriptive and analytical, single-center study was conducted in the Department of Cardiology, Ibn Sina University Hospital, Rabat, Morocco, from January 2025 to April 2026. Patients with imaging-confirmed ischemic stroke, no previously known AF, and a 24–72-hour ambulatory Holter ECG were included. Of 1,431 Holter recordings performed during the study period, 60 concerned stroke patients; three were excluded for insufficient data, leaving 57 patients. Age, sex, hypertension, and type 2 diabetes were recorded.