Figure 4: Example of a long-term ECG-recording of a stroke patient with an acute cerebral infarction of undetermined cause. A total of 68 hours was recorded, whereof 6 hours were classified as risk level 0 (sinus rhythm), 2 hours as risk level 2 (risk of atrial fibrillation) and 60 hours of risk level 1 (indication risk for AF). Above, showcases of the heart rhythm of hour 19 (risk level 1, A) and hour 38 (risk level 2, B) are displayed.
Given that only 2 hours of the ECG showed AF, a conventional Holter-ECG would likely have missed the diagnosis of paroxysmal AF, i.e. when monitored during the first 37 hours. Conversely, EPA graded 60 of 66 hours of sinus rhythm as having a risk for AF, along with classifying the 2 hours of AF correctly as level 2.