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Abstract：
BACKGROUND: Atrial fibrillation is responsible for a considerable number of cases of cardioembolism, accounting for 17% to 30% of the etiologies of all strokes. The software known as Stroke Risk Analysis (SRA) detects patients at high risk of paroxysmal atrial fibrillation by analyzing a continuous electrocardiogram recorded over different periods of time.
OBJECTIVE: This article aims to carry out a systematic review investigating the effectiveness of the SRA method in predicting the risk of stroke patients having paroxysmal atrial fibrillation as the cause of the event.
METHODS: The methods correspond to the format of the International Prospective Register of Systematic Reviews Protocol, according to CRD Identification Code: CRD42021253974. A systematic search was carried out in BMJB, PubMed/MEDLINE, Science Direct and LILACS. Six cohort studies met the inclusion criteria, representing a total of 2,088 participants with stroke, and compared the detection of patients with paroxysmal atrial fibrillation on the continuous recording electrocardiogram with a time variation of 1 to 48h with the use of SRA.
RESULTS: Studies have shown that SRA has a high negative predictive value (between 96 and 99.1%) and can contribute to the selection of patients at high risk of paroxysmal atrial fibrillation to be referred for implantable cardiac monitoring to continue the investigation.
CONCLUSIONS: A sequential combination of SRA with implantable cardiac monitoring is a promising strategy for detecting undiagnosed paroxysmal atrial fibrillation. Thus, the SRA can act as a cost-effective pre-selection tool to identify patients at higher risk of having paroxysmal atrial fibrillation as a possible cause of stroke and who may benefit from implantable cardiac monitoring. However, the lack of randomized studies is a limitation that must be considered.
OBJECTIVE: This article aims to carry out a systematic review investigating the effectiveness of the SRA method in predicting the risk of stroke patients having paroxysmal atrial fibrillation as the cause of the event.
METHODS: The methods correspond to the format of the International Prospective Register of Systematic Reviews Protocol, according to CRD Identification Code: CRD42021253974. A systematic search was carried out in BMJB, PubMed/MEDLINE, Science Direct and LILACS. Six cohort studies met the inclusion criteria, representing a total of 2,088 participants with stroke, and compared the detection of patients with paroxysmal atrial fibrillation on the continuous recording electrocardiogram with a time variation of 1 to 48h with the use of SRA.
RESULTS: Studies have shown that SRA has a high negative predictive value (between 96 and 99.1%) and can contribute to the selection of patients at high risk of paroxysmal atrial fibrillation to be referred for implantable cardiac monitoring to continue the investigation.
CONCLUSIONS: A sequential combination of SRA with implantable cardiac monitoring is a promising strategy for detecting undiagnosed paroxysmal atrial fibrillation. Thus, the SRA can act as a cost-effective pre-selection tool to identify patients at higher risk of having paroxysmal atrial fibrillation as a possible cause of stroke and who may benefit from implantable cardiac monitoring. However, the lack of randomized studies is a limitation that must be considered.
摘要：
背景：心房颤动是相当多的心栓塞病例的原因，占所有中风病因的17％至30％。称为中风风险分析（SRA）的软件通过分析在不同时间段记录的连续心电图来检测阵发性房颤的高风险患者。
目的：本文旨在进行系统评价，探讨SRA方法在预测阵发性房颤作为事件原因的卒中患者风险方面的有效性。
方法：这些方法符合《国际前瞻性系统审查注册议定书》的格式，根据CRD识别码：CRD42021253974。在BMJB中进行了系统的搜索，PubMed/MEDLINE,科学直接和LILACS。六项队列研究符合纳入标准，代表总共2088名中风参与者，并比较了使用SRA对阵发性房颤患者在1～48h时间变化的连续记录心电图的检测。
结果：研究表明，SRA具有较高的阴性预测值（96％至99.1％），有助于选择阵发性房颤高危患者进行植入式心脏监测以继续研究。
结论：SRA与植入式心脏监测的序贯组合是检测未诊断的阵发性心房颤动的有希望的策略。因此，SRA可以作为一种具有成本效益的预选工具,用于将阵发性心房颤动风险较高的患者确定为卒中的可能原因,并可从植入式心脏监测中获益.然而,缺乏随机研究是一个必须考虑的局限性.
目的：本文旨在进行系统评价，探讨SRA方法在预测阵发性房颤作为事件原因的卒中患者风险方面的有效性。
方法：这些方法符合《国际前瞻性系统审查注册议定书》的格式，根据CRD识别码：CRD42021253974。在BMJB中进行了系统的搜索，PubMed/MEDLINE,科学直接和LILACS。六项队列研究符合纳入标准，代表总共2088名中风参与者，并比较了使用SRA对阵发性房颤患者在1～48h时间变化的连续记录心电图的检测。
结果：研究表明，SRA具有较高的阴性预测值（96％至99.1％），有助于选择阵发性房颤高危患者进行植入式心脏监测以继续研究。
结论：SRA与植入式心脏监测的序贯组合是检测未诊断的阵发性心房颤动的有希望的策略。因此，SRA可以作为一种具有成本效益的预选工具,用于将阵发性心房颤动风险较高的患者确定为卒中的可能原因,并可从植入式心脏监测中获益.然而,缺乏随机研究是一个必须考虑的局限性.
