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WSC 2025 | How premature atrial complexes detected on ECG impact clinical decisions: the need for more data

Rolf Wachter, MD, PhD, University Hospital Leipzig, Leipzig, Germany, discusses how premature atrial complexes, a marker of atrial fibrillation and stroke risk, detected on a routine echocardiogram (ECG) should influence clinical decisions. Prof. Wachter highlights the need for more intensive screening and emphasizes that the lack of data on the impact of screening on reducing recurrent stroke risk is a major barrier to change. This interview took place at the 17th World Stroke Congress (WSC) in Barcelona, Spain.

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Transcript

I wish it would have some impact. In my personal opinion, it usually does not have. We write, for instance, in the how to ECG report, it’s often not reported. If it’s reported, it’s neglected. So it’s not taken care of. As the data that we have shows the risk of atrial fibrillation is increased, I think it should, in an ideal world, trigger some more intensity in, for instance, AF screening in stroke patients...

I wish it would have some impact. In my personal opinion, it usually does not have. We write, for instance, in the how to ECG report, it’s often not reported. If it’s reported, it’s neglected. So it’s not taken care of. As the data that we have shows the risk of atrial fibrillation is increased, I think it should, in an ideal world, trigger some more intensity in, for instance, AF screening in stroke patients. But at the moment, it does not. And probably one reason for that is that we lack the data to show, yes, we have to do more screening because we will find more atrial fibrillation and this may perhaps have an impact in reducing the risk of recurrent stroke. That data is missing at the moment.

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