Key result
Among patients with low TSH levels in the first tertile, screening with an implantable loop recorder significantly reduced the risk of stroke or systemic embolism compared to usual care (aHR 0.52).
Why the study?
Does systematic screening for atrial fibrillation using an implantable loop recorder reduce the incidence of stroke or systemic embolization in patients without known AF, and is this effect modified by baseline TSH levels?
Does systematic screening for atrial fibrillation using an implantable loop recorder reduce the incidence of stroke or systemic embolization in patients without known AF, and is this effect modified by baseline TSH levels?
Hazard Ratio: 0.52 (95% CI 0.3–0.9)
p-value: p=0.02
Lower serum TSH levels may help identify a higher-risk phenotype that derives significant clinical benefit (reduction in stroke/systemic embolization) from systematic AF screening with an implantable loop recorder.
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Mavilakandy et al. (2026) conducted an editorial in Undiagnosed atrial fibrillation (n=6,003). Implantable loop recorder (ILR) with continuous rhythm monitoring vs. Usual care was evaluated on Incidence of stroke or systemic embolism (SE) events (aHR 0.52, 95% CI 0.30-0.90, p=0.02). Among patients with low TSH levels in the first tertile, screening with an implantable loop recorder significantly reduced the risk of stroke or systemic embolism compared to usual care (aHR 0.52).
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