Work-related activities during non-work time.

Objective: Prolonged monitoring times (72h) are recommended to detect paroxysmal atrial fibrillation (pAF) after ischemic stroke, but not yet clinical practice; therefore, an individual patient selection for prolonged ECG monitoring might increase the diagnostic yield of pAF in a resource-saving manner. Methods: We used individual patient data from three prospective studies (ntotal=1556) performing prolonged Holter ECG monitoring (at least 72h) and centralized data evaluation after TIA or stroke in patients with sinus rhythm. Based on the TRIPOD guideline, a clinical score was developed on one cohort, internally validated by bootstrapping and externally validated on two other studies. Results: pAF was detected in 77 (4.9%) of 1556 patients during 72h-Holter monitoring. After logistic regression analysis with variable selection, age and the qualifying stroke event (categorised as stroke severity with NIH-SS≤5 (OR 2.4 vs. TIA; 95%CI0.8-6.9,p=0.112) or stroke with NIH-SS>5 (OR 7.2 vs. TIA; 95%CI 2.4-21.8,p<0.001)) were found to be predictive for the detection of pAF within 72h-Holter monitoring and included in the final score (Age: 0.76 points/year, Stroke Severity NIH-SS≤5 = 9 points, NIH-SS>5 = 21 points; to Find AF, AS5F). The high risk group defined by AS5F is characterized by a predicted risk between 5.2% and 40.8% for detection of pAF with a number needed to screen of 3 for the highest observed AS5F points within the study population. Regarding the low number of outcomes before generalization of AS5F the results need replication. Conclusion: The AS5F score can select patients for prolonged ECG monitoring after ischemic stroke to detect pAF.

The improved six-factor model.

Initial scale with 23 items.

This test dataset comprised of 800 24-hour Holter recordings from the test set of the randomized clinical cohort in the paper. Each recording includes the RR-interval data that are extracted from a 24-hour dynamic 12-lead ECG recording captured by a Holter machine (DMS Holter Company, Stateline, NV, USA) at three campuses (Main Campus, Optical Valley Campus, and Sino-French New City Campus) of the Cardiac Function Examination Center (Division of Cardiology, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China). All the data were initially interpreted by primary cardiologists, then were further reviewed by three senior board-certified cardiologists to ensure the correctness of the base diagnostic labels. The cardiologist committees discussed by consensus the annotated records and provided a reference standard for model evaluation. Each atrial fibrillation(AF) episode included the accurately labeled start time and end time for patients with paroxysmal AF (PAF). The start and end times of each PAF episode were the corresponding time of the first atrial wave with an atrial rate greater than 350 beats/min and the corresponding time of the first P-wave with sinus rhythm after the termination of AF. Specifically, PAF episodes lasting more than 30 s were accurately labeled, and those lasting less than 30 s were labeled as accurately as possible. Moreover, each interval of premature beat or tachycardia was marked as “A” (atrium event) or “V” (ventricle event), and the long RR interval caused by QRS wave dropping was marked as “B” to further label Second-degree atrioventricular block. The 800 recordings included 200 whole-course AF (WAF), 200 PAF and 400 NAF recordings. For WAF patient data, whole recording included only AF signals. For NAF patients, the entire recording data had no AF signals but included normal sinus rhythm, sinus arrhythmia, atrial arrhythmia, ventricular arrhythmia, atrioventricular block and so on. The data of PAF patients included both AF episodes and NAF signals. Both WAF and PAF patients were considered to be AF patients. The type of each recording is indicated by its file name and the comments on the contents can be seen in the picture "Note.jpg".