Cryptogenic stroke and atrial fibrillation in a real-world population: the role of insertable cardiac monitors

6533b832fe1ef96bd129adf2

RESEARCH PRODUCT

Cryptogenic stroke and atrial fibrillation in a real-world population: the role of insertable cardiac monitors

Raffaella Franciotti Enrico Di Girolamo Maria Vittoria De Angelis Massimiliano Faustino Marco Onofrj Vincenzo Di Stefano Nanda Furia

subject

Male lcsh:Medicine Kaplan-Meier Estimate 030204 cardiovascular system & hematology Severity of Illness Index 0302 clinical medicine Risk Factors lcsh:Science Stroke Multidisciplinary Incidence (epidemiology)Q R Neuro-vascular interactions Atrial fibrillation ICM device Stroke Treatment Outcome Cardiology Medicine Female Settore MED/26 - Neurologia medicine.symptom medicine.medical_specialty Science Neurophysiology Cryptogenic stroke Asymptomatic Article Prosthesis Implantation Loop recorder 03 medical and health sciences Internal medicine medicine Humans Aged Monitoring Physiologic business.industry lcsh:R Anticoagulants medicine.disease Atrial fibrillation Clinical trial Cryptogenic stroke Anticoagulant therapy Electrocardiography Ambulatory Cardiac monitors lcsh:Q business 030217 neurology & neurosurgery Follow-Up Studies

description

AbstractThe incidence of atrial fibrillation (AF) in cryptogenic stroke (CS) patients has been studied in carefully controlled clinical trials, but real-world data are limited. We investigated the incidence of AF in clinical practice among CS patients with an insertable cardiac monitor (ICM) placed for AF detection. Patients with CS admitted to our Stroke Unit were included in the study; they received an ICM and were monitored for up to 3 years for AF detection. All detected AF episodes of at least 120 sec were considered. From March 2016 to March 2019, 58 patients (mean age 68.1 ± 9.3 years, 67% male) received an ICM to detect AF after a CS. No patients were lost to follow-up. AF was detected in 24 patients (41%, AF group mean age 70.8 ± 9.4 years, 62% male) after a mean time of 6 months from ICM (ranging from 2 days to 2 years) and 8 months after CS (ranging from 1 month to 2 years). In these AF patients, anticoagulant treatment was prescribed and nobody had a further stroke. In conclusion, AF episodes were detected via continuous monitoring with ICMs in 41% of implanted CS patients. AF in CS patients is asymptomatic and difficult to diagnose by strategies based on intermittent short-term recordings. Therefore, we suggest that ICMs should be part of daily practice in the evaluation of CS patients.

year	journal	country	edition	language
2020-02-01	Scientific Reports

https://doi.org/10.1038/s41598-020-60180-6