What is the clinical evidence from this study?

Study design: Cohort. Population: cryptogenic stroke (n=475). Intervention: Insertable cardiac monitors (ICM) vs. Standard care without ICM. Primary outcome: Functional disability at 3 months assessed by modified Rankin Scale (mRS) (OR 0.77, 95% CI 0.50-1.20, p=0.22).

What does this research mean for the field?

Insertable cardiac monitoring after cryptogenic stroke in women is not associated with worse functional disability or impaired quality of life at 3 months compared to standard care. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

This research aims to assess the impact of insertable cardiac monitors on functional disability and quality of life in women after a cryptogenic stroke.

May 8, 2026Open Access

Abstract Number: Esoc2026a1129 Health-Related Quality of Life After Cryptogenic Stroke in Women: Impact of Early Insertable Cardiac Monitoring in the Strokewise Cohort Study

Key Result

Insertable cardiac monitoring after cryptogenic stroke in women was not associated with worse functional disability at 3 months compared to standard care (OR 0.77; 95% CI 0.50-1.20; p=0.22).

Key Points

This research aims to assess the impact of insertable cardiac monitors on functional disability and quality of life in women after a cryptogenic stroke.
Recruited women with acute cryptogenic stroke from two university hospitals (2016–2023).
One center used insertable cardiac monitors, while the control group received standard care.
Functional outcomes at 3 months were evaluated using the modified Rankin scale and EQ-5D-5L.
No significant difference in functional disability between ICM and control groups (OR 0.77, 95% CI 0.50–1.20, p = 0.22).
EQ-5D data showed high scores for both groups, indicating mostly none/mild symptoms, with median EQ-VAS of 75.
Women with ICM did not report higher levels of pain or anxiety compared to controls.

Study Design

Type

Cohort (n=475)

Multicenter

Yes

Structured PICO

Does early insertable cardiac monitoring worsen functional disability or quality of life in women after cryptogenic stroke?

Population

475 women with acute cryptogenic stroke, mean age 73 ± 12 years.

Intervention

Insertable cardiac monitor (ICM) placed median 4 days after stroke

Comparator

Standard care without ICM

Outcome

Functional outcome at 3 months assessed by the modified Rankin Scale (mRS)patient reported

Early insertable cardiac monitoring after cryptogenic stroke in women does not worsen functional disability or quality of life at 3 months, supporting its patient acceptability.

Main Result

Effect estimate: OR 0.77 (95% CI 0.50-1.20)

p-value: p=0.22

Abstract

Abstract Background and aims Insertable cardiac monitors (ICMs) improve detection of atrial fibrillation after cryptogenic stroke but represent an invasive procedure. Patient-reported outcomes after ICM are limited. We investigated functional disability and patient-reported outcomes in women undergoing ICM after cryptogenic stroke. Methods We recruited patients with acute cryptogenic stroke at two university hospitals with different diagnostic strategies (2016–2023). At one centre, patients received ICM while the other centre followed standard care without ICM (control group). Functional outcome at 3 months was assessed by the modified Rankin Scale (mRS) and adjusted ordinal regression. Health-related quality of life at 3 months measured by EQ-5D-5L domains and EQ-VAS (EuroQol-5 Dimensions Visual Analogue Scale), available from 2019 onwards. Results Among 475 women with cryptogenic stroke (mean age 73 ± 12 years), 262 received ICM (median 4 days after stroke), and 3-month mRS was available in 82% of the total cohort. There was no significant difference in functional disability between groups (OR 0.77, 95% CI 0.50–1.20, p = 0.22). Age independently predicted poorer outcome. EQ-5D data were available for 169 women in the ICM group and 95 controls. EQ-VAS scores were similar between groups (median 75 in both), mostly reporting none/mild symptoms across EQ-5D domains. Importantly, women undergoing ICM did not report higher levels of pain or anxiety. Conclusions ICM after cryptogenic stroke in women was not associated with worse functional disability or impaired quality of life at 3 months. These findings support the safety and patient acceptability of invasive rhythm monitoring. Conflict of interest Jannicke Koldéus-Falch; nothing to disclose.