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July 11, 2019The Siberian Journal of Clinical and Experimental MedicineOpen Access

Efficacy of Atrial Fibrillation Detection in Cryptogenic Stroke According to Data of Implantable Loop Recorders: Pilot Study

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Why the study?

The efficacy of invasive and non-invasive long-term ECG monitoring compared with conventional follow-up for detecting silent AF, AFL, or AT in cryptogenic stroke patients needed to be estimated.

Does long-term ECG monitoring with implantable loop recorders or noninvasive systems improve the detection of silent atrial fibrillation in patients with cryptogenic stroke compared to standard monitoring?

Population

36 patients with cryptogenic stroke or TIA without history of AF/AFL/AT

Comparison

Standard arrhythmia monitoring vs implantable loop recorder vs ambulatory noninvasive ECG monitoring

Design

Randomized, prospective, two-center study

Follow-up

1 year

Authors

СМС. Е. МамчурTheranostics (New Zealand)EIE. A. IvanitskiyFederal State Budgetary Institution "Federal Center For Cardiovascular Surgery" Ministry of Health of The Russian FederationОПО. М. ПоликутинаResearch Institute of Complex Problems of Cardiovascular Disease Russian Academy of Medical Sciences

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Implication

Supports implantable loop recorders for superior silent arrhythmia detection in cryptogenic stroke; extends evidence favoring prolonged monitoring over standard approaches.

Structured PICO

Does long-term ECG monitoring with implantable loop recorders or noninvasive systems improve the detection of silent atrial fibrillation in patients with cryptogenic stroke compared to standard monitoring?

P
Population
36 patients who suffered cryptogenic stroke (CS) or transient ischemic attack (TIA) without past history of atrial fibrillation (AF), atrial flutter (AFL), or atrial tachycardia (AT).
I
Intervention
ECG-monitoring with implantable loop recorder (Reveal XT) with daily remote data transmission (n=12) or ambulatory noninvasive ECG monitoring (Spyder system) for up to 28 days (n=12).
C
Comparator
Standard arrhythmia monitoring (n=12) with scheduled and unscheduled visits and ambulatory ECG monitoring 28 days and 1 year after randomization.
O
Outcome
Time to the first detection of AF/AFL/AT.surrogate

Implantable cardiac monitors are superior to standard and long-term external monitoring for detecting silent atrial fibrillation in patients with cryptogenic stroke.

Cite This Study

Мамчур et al. (2019) studied this question.

synapsesocial.com/papers/6a07b43c9090d046d755d09chttps://doi.org/10.29001/2073-8552-2019-34-2-47-53

Topics

Persistent AF managementAtrial fibrillationAnticoagulation in AFAF ablation outcomes
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Detection of Atrial Fibrillation After Ischemic Stroke or Transient Ischemic Attack2014 · 378 citations
  2. 2Cryptogenic Stroke and Underlying Atrial Fibrillation2014 · 2,175 citations
  3. 3Targeted Anticoagulation for Atrial Fibrillation Guided by Continuous Rhythm Assessment With an Insertable Cardiac Monitor: The Rhythm Evaluation for Anticoagulation With Continuous Monitoring (REACT.COM) Pilot Study2015 · 115 citations
  4. 4Meta-analysis: Antithrombotic Therapy to Prevent Stroke in Patients Who Have Nonvalvular Atrial Fibrillation2007 · 4,830 citations
  5. 5Risk of recurrent stroke, myocardial infarction, or death in hospitalized stroke patients2010 · 157 citations