Key result
External cardiac monitoring detects 11% AF incidence at one year after cryptogenic stroke.
Why the study?
AF is a major risk factor for ischemic stroke and cardioembolism, motivating evaluation of the incidence of AF in patients presenting with cryptogenic stroke.
Does prolonged electrocardiographic monitoring detect atrial fibrillation in patients with cryptogenic stroke?
Observational (n=100)
No
Does prolonged electrocardiographic monitoring detect atrial fibrillation in patients with cryptogenic stroke?
Prolonged electrocardiographic monitoring after cryptogenic stroke detects atrial fibrillation in 11% of patients at 1 year, highlighting the need for extended monitoring in high-risk patients to guide anticoagulation therapy.
May support extended monitoring in cryptogenic stroke; leaves open randomized confirmation of outcome benefit.
Background: Stroke can cause serious disability and mortality among the worldwide population. Atrial fibrillation (AF) is one of the major risk factors for ischemic stroke and a common cause of cardioembolism in old age. Aims and Objectives: The aim of the study was to study the incidence of AF in patients with cryptogenic stroke (CS). Materials and Methods: A prospective and observational study on AF and stroke was carried out in the Department of Cardiology/Neurology, in a tertiary care hospital. Data were collected in the form of chief complaints, medical history, clinical examination, and treatment given in the enclosed proforma for 1 year. On follow-up, specified goals including hypertension (HTN) management, lipid management, and diabetes management were done as per current guidelines. Results: Out of 100 CS patients, 69 were male and the mean age of the patients in this study was 59±13.37 years. The incidence of AF was 11% at the end of 1 year with male predominance (64%) and a mean age of 62±12.94 years. The mean CHADS2 Score in this study group was 1.40 with a standard deviation of 1.31. Stroke reoccurred in 12% of patients at the end of 1-year follow-up. Patients with recurrent stroke were mostly elderly with a mean age of 70 years (SD=9.78, P=0.03). Conclusion: It is found that a longer duration of electrocardiographic monitoring after CS increases the proportion diagnosed with AF and should be done in selected high-risk cases, especially in patients with HTN, dyslipidemia, diabetes mellitus, chronic kidney disease, and high CHADS2 score.
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Sachdeva et al. (2022) conducted an observational in Cryptogenic stroke (n=100). External cardiac monitoring (Event Loop Recorder/Patch Holter) was evaluated on Incidence of atrial fibrillation. External cardiac monitoring detected an 11% incidence of atrial fibrillation at 1 year in patients with cryptogenic stroke.
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