Atrial Tachycardia in Patients with Cryptogenic Stroke: Is there a Need For Anticoagulation?

Background: Brief episodes of atrial tachycardia are a common finding in the Halter monitor recordings of elderly patients. Episodes of atrial tachycardia may convert to atrial fibrillation. Current guidelines do not recommend anticoagulant therapy in patients with atrial tachycardia and risk factors for embolism. Objectives: To assess the incidence of atrial tachycardia in a 24 hour Hotter monitor recording of patients admitted to hospital with ischemic stroke. Methods: The patient cohort included two groups: 134 patients admitted with a diagnosis of ischemic stroke (the study group), and 68 consecutive patients with a diagnosis of syncope (the control group). Both groups used a Hotter monitor. Results: There was no difference in the incidence of atrial tachycardia runs between the groups. Patients who suffered a stroke were more likely to be hypertensive (P < 0.05) and more likely to have a CHA2DS2-VASc score of >= 3 (P = 0.05). Conclusions: Atrial tachycardia as recorded on a Halter monitor was not more prevalent in patients presenting with ischemic stroke. The occurrence of atrial tachycardia is not an indication for systemic anticoagulation.