Paroxysmal Atrial Fibrillation (PFA) Detection With Cardiac Monitoring Devices Implanted by Neurologists in Patients With Embolic Strokes of Undetermined Source (ESUS)

Introduction Ischemic stroke is among the leading causes of death and disability. Approximately 50% of cryptogenic strokes are embolic strokes of undetermined source (ESUS). The most common cause of ESUS is atrial fibrillation. Therefore, the detection of atrial fibrillation with long-term implantable devices is needed. Neurologists are directly involved with acute and post-acute stroke care and have direct access to the management of stroke patients. Therefore, there is a need for neurologists to recommend, implant, and monitor cardiac implantable devices in patients with ESUS. Methods From November 2022 to October 2023, our group implanted 32 ESUS patients with Confirm Rx™ insertable cardiac monitors (Abbott, USA). Atrial fibrillation detection was supervised and monitored daily. Results In 24 months, atrial fibrillation was detected in 12.5% of patients (four patients), sinus bradycardia in 6.25% of patients (two patients), paroxysmal supraventricular tachycardia in 9.4% of patients (three patients), and asystole in one patient. Conclusion Our study shows that neurologists involved in the treatment of stroke care can safely implant, monitor, and detect atrial fibrillation accurately. Our rate of detection of atrial fibrillation in patients with ESUS was 12.8%, which is consistent with prior studies.