Nurse–led Remote Monitoring and Triage of Patients With Implantable Loop Recorder for Cryptogenic Stroke: Experience at Annunziata Hospital, Cosenza

Background Implantable loop recorders (ILRs) are increasingly used to identify occult arrhythmias in patients with cryptogenic stroke. The active involvement of nurses in device management and data triage plays a pivotal role in ensuring accurate interpretation and timely clinical action. Methods This single–center, real–world experience included 84 patients implanted with ILRs for suspected cryptogenic stroke at the Diagnostic Center of Annunziata Hospital, Cosenza, between 2021 and 2025. Nurses managed all stages of care: patient preparation and procedural assistance, remote data monitoring, and systematic data collection through a dedicated digital platform. A structured nurse–led triage workflow was implemented to classify arrhythmic events and coordinate multidisciplinary decision–making. Results Subclinical atrial fibrillation (AF) was detected in approximately 29% of patients, while other identified events included sinus pauses, supraventricular tachycardias, and bradyarrhythmias. Nurse–driven review enabled clear differentiation between actionable and non–actionable events, optimizing communication with physicians and facilitating timely initiation of therapies such as anticoagulation, antiarrhythmics, pacing, or ablation. At 24 months, cumulative AF incidence reached 29%, increasing to 37% at 48 months (Figure 1). Event distribution analysis confirmed AF as the predominant finding, followed by pauses and supraventricular tachycardias. (Figure 2)This data confirms the importance of nurse triage in remote monitoring for timely and targeted diagnosis Conclusion This experience underscores the essential contribution of nurses in remote monitoring programs for patients with ILRs implanted after cryptogenic stroke. Their expertise in digital surveillance, clinical triage, and multidisciplinary coordination enhances diagnostic yield, supports early therapeutic interventions, and ensures personalized and safe patient management.Figure 1.The cumulative incidence of FA in patients monitored with ILR reached 29% at 24 months and 37% at 48 months Figure 2.shows the distribution of the main diagnosed arrhythmias. FA represents the majority of events, followed by sinus pauses and supra ventricular tachycardias