In cryptogenic stroke patients with a CHA2DS2-VASc score <4 and age <65 years, only 1 patient (<1%) with a recurrent stroke had atrial fibrillation detected by an insertable cardiac monitor.
Cohort
No
Does the detection of atrial fibrillation by insertable cardiac monitors predict stroke recurrence in patients with cryptogenic stroke or transient ischemic attack?
Despite high rates of AF detection by ICMs following cryptogenic stroke, most recurrent strokes in this population may not be attributable to AF, particularly in younger, lower-risk patients.
BACKGROUND: Insertable cardiac monitors (ICMs) are often implanted after cryptogenic stroke (CS) to detect atrial fibrillation (AF) and guide anticoagulation. However, the impact of this practice on stroke recurrence remains unclear. OBJECTIVES: This study sought to compare stroke recurrence between CS patients with and without ICM-detected AF and identify predictors of recurrent stroke. METHODS: A retrospective analysis was conducted of consecutive patients admitted to a stroke center with no history of AF who received an ICM for CS or transient ischemic attack. RESULTS: -VASc score <4 and age of <65 years (n = 107), only 1 patient with a recurrent stroke had AF detected (<1%). CONCLUSIONS: Despite the high rate of detection of AF following CS by ICMs, most strokes occurring in this population may not be due to AF. Further randomized trials are needed to verify these observations and clarify the benefit of routine ICM implantation for secondary CS prevention.
Bharucha et al. (Tue,) conducted a cohort in Cryptogenic stroke or transient ischemic attack. Insertable cardiac monitors (ICMs) vs. Without ICM-detected AF was evaluated on Stroke recurrence. In cryptogenic stroke patients with a CHA2DS2-VASc score <4 and age <65 years, only 1 patient (<1%) with a recurrent stroke had atrial fibrillation detected by an insertable cardiac monitor.
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