Implantable cardiac monitors detected atrial fibrillation in 28.5% of patients with cryptogenic stroke or embolic stroke of undetermined source after 36 months of monitoring.
Meta-Analysis (n=8,215)
What are the atrial fibrillation detection rates and predictors across different rhythm monitoring strategies in patients with cryptogenic stroke or ESUS?
Non-invasive rhythm monitoring detects AF in about 1 in 7 patients within a month, suggesting it should be considered before invasive monitoring in patients with cryptogenic stroke.
OBJECTIVE: To summarize data on atrial fibrillation (AF) detection rates and predictors across different rhythm monitoring strategies in patients with cryptogenic stroke (CS) or embolic stroke of undetermined source (ESUS). METHODS: MEDLINE, Embase, and Web of Science were searched to identify all published studies providing relevant data through July 6, 2020. Random-effects meta-analysis method was used to pool estimates. RESULTS: -VASc score, left atrial enlargement, P wave maximal duration and prolonged PR interval. CONCLUSION: The yield of ICM increases with the duration of monitoring. More than a quarter of patients with CS or ESUS will be diagnosed with AF during follow-up. About one in seven patients had AF detected within a month of MCOT, suggesting that a non-invasive rhythm monitoring strategy should be considered before invasive monitoring.
Noubiap et al. (Mon,) conducted a meta-analysis in Cryptogenic stroke (CS) or embolic stroke of undetermined source (ESUS) (n=8,215). Implantable cardiac monitor (ICM) was evaluated on Atrial fibrillation detection rate at 36 months (95% CI 17.6-39.3). Implantable cardiac monitors detected atrial fibrillation in 28.5% of patients with cryptogenic stroke or embolic stroke of undetermined source after 36 months of monitoring.