Implantable Loop Recorders for Cryptogenic Stroke (Plus Real-World Atrial Fibrillation Detection Rate with Implantable Loop Recorders)

2018 ◽  
Vol 10 (1) ◽  
pp. 111-118 ◽  
Author(s):  
Dan L. Musat ◽  
Nicolle Milstein ◽  
Suneet Mittal
Keyword(s):  
Atrial Fibrillation ◽  
Real World ◽  
Detection Rate ◽  
Cryptogenic Stroke ◽  
Implantable Loop Recorders ◽  
Atrial Fibrillation Detection

scholarly journals P1066Predictors of atrial fibrillation detection in patients with implantable loop recorders for cryptogenic stroke

EP Europace ◽  
2017 ◽  
Vol 19 (suppl_3) ◽  
pp. iii234-iii234
Author(s):  
B. Yeneneh ◽  
J. Munro ◽  
S. Wilansky ◽  
J. Behai ◽  
L. Scott
Keyword(s):  
Atrial Fibrillation ◽  
Cryptogenic Stroke ◽  
Implantable Loop Recorders ◽  
Atrial Fibrillation Detection

scholarly journals Three year incidence and duration of atrial fibrillation episodes among a large, real-world population of cryptogenic stroke patients with insertable cardiac monitors

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
P.D Ziegler ◽  
J.D Rogers ◽  
M Richards ◽  
A.J Nichols ◽  
S.W Ferreira ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Real World ◽  
Stroke Prevention ◽  
Detection Rate ◽  
Large Population ◽  
Cryptogenic Stroke ◽  
World Population ◽  
Median Frequency ◽  
Secondary Stroke Prevention

Abstract Background/Introduction The primary goal of monitoring for atrial fibrillation (AF) after cryptogenic stroke (CS) is secondary stroke prevention. Therefore, long-term monitoring of CS patients with insertable cardiac monitors (ICMs) is likely important to ensure appropriate secondary stroke prevention therapy, regardless of when AF is detected after the index event. However, long-term data on the incidence and duration of AF from real-world populations are sparse. Purpose To investigate the long-term incidence and duration of AF episodes in real-world clinical practice among a large population of patients with ICMs placed for AF detection following CS. Methods We included patients from a large device manufacturer's database who received an ICM for the purpose of AF detection following CS and were monitored for up to 3 years. All detected AF episodes (≥2 minutes) were adjudicated. We quantified the AF detection rate for various episode duration thresholds using Kaplan-Meier survival estimates, analyzed the maximum duration of AF episodes, and measured the time to initial AF detection. Results A total of 1247 patients (65.3±13.0 years, 53% male) were included and followed for 763±362 days. AF episodes (n=5456) were detected in 257 patients, resulting in a median frequency of 5 episodes [IQR 2–19] per patient. At 3 years, the AF detection rate for episodes ≥2 minutes was 24.2%. The AF detection rates at 3 years for episodes ≥6 minutes, ≥30 minutes, and ≥1 hour were 22.4%, 20.6%, and 19.1%, respectively. The median duration of the longest detected AF episode was 4.4 [IQR 1.2–13.9] hours and the median time to AF detection was 129 [IQR 45–354] days. Conclusion AF episodes were detected via ICMs in approximately one-quarter of CS patients within 3 years of follow-up. More than 75% of patients with AF detected had episodes lasting ≥1 hour and half had episodes lasting ≥4 hours. Detection of the first AF episode typically occurred beyond the range of conventional ambulatory monitors. Long-term surveillance of CS patients is likely important given the appreciable incidence, frequency, and duration of these AF episodes. Funding Acknowledgement Type of funding source: None

Abstract TMP40: Impact of Age on Atrial Fibrillation Detection among a Large, Real-World Population of Cryptogenic Stroke Patients with Insertable Cardiac Monitors

Stroke ◽  
2016 ◽  
Vol 47 (suppl_1) ◽  
Author(s):  
Mark Richards ◽  
John D Rogers ◽  
Scott W Ferreira ◽  
Allan J Nichols ◽  
Jodi L Koehler ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Median Time ◽  
Real World ◽  
Detection Rate ◽  
Recurrent Stroke ◽  
Anticoagulation Therapy ◽  
Cryptogenic Stroke ◽  
World Population ◽  
Time To Detection ◽  
The Impact

Introduction: Detection of atrial fibrillation (AF) in patients with a cryptogenic stroke (CS) is critical for reducing the risk of recurrent stroke by enabling oral anticoagulation therapy. However, the impact of age on AF detection and the optimum duration of AF monitoring in patients following a CS is not well characterized. We investigated the impact of age on AF detection among a large, real-world cohort of unselected patients with an implantable cardiac monitor (ICM) placed following CS. Methods: Patients in the de-identified Medtronic Discovery™ Link database who received an ICM (Reveal LINQ™) for AF detection following CS were included and monitored for up to 182 days. All AF episodes were adjudicated. We compared the mean age between patients with vs. without AF detected and compared the median time to detection of the first AF episode between younger (age ≤65) and older (age >65) patients. Results: Among 1247 patients (mean age 65.3±13.0, 53% male) followed for 182 [IQR 182-182] days, 1521 AF episodes were detected in 147 patients and resulted in an AF detection rate of 12.2%. Patients with AF detected were significantly older than patients without AF detected (71.3±10.9 vs. 64.5±13.1 years, respectively; p<0.001). The median time to detection of the first AF episode was shorter for older vs. younger patients (43 [10-91] vs. 89 [29-127] days, respectively; p=0.016; Figure). Conclusion: Continuous monitoring of CS patients with an ICM resulted in an AF detection rate of 12.2% within the initial 6 months. Patients with AF detected were older and patients >65 years of age had shorter times to initial AF detection. However even among older patients, the majority of AF occurred outside the range of external monitoring devices and thus highlights the importance of long-term monitoring with ICMs in the management of CS patients.

scholarly journals Predictors for atrial fibrillation detection after cryptogenic stroke

Neurology ◽  
2015 ◽  
Vol 86 (3) ◽  
pp. 261-269 ◽  
Author(s):  
Vincent N. Thijs ◽  
Johannes Brachmann ◽  
Carlos A. Morillo ◽  
Rod S. Passman ◽  
Tommaso Sanna ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Cryptogenic Stroke ◽  
Atrial Fibrillation Detection

P3859Long-term noninvasive ecg monitoring in atrial fibrillation detection in patients after cryptogenic stroke

2018 ◽  
Vol 39 (suppl_1) ◽  
Author(s):  
V Bulkova ◽  
P Jansky ◽  
D Kovarikova ◽  
H Alfredova ◽  
V Dlugosova ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Cryptogenic Stroke ◽  
Ecg Monitoring ◽  
Atrial Fibrillation Detection

scholarly journals 153-03: Echocardiographic Predictors of Atrial Fibrillation Detection with Injectable Loop Recorders for Patients with Cryptogenic Stroke

EP Europace ◽  
2016 ◽  
Vol 18 (suppl_1) ◽  
pp. i112-i112
Author(s):  
Jeffrey Munro ◽  
Wilansky Susan ◽  
Duddyala Narendra ◽  
Luis Scott ◽  
Win-Kuang Shen ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Cryptogenic Stroke ◽  
Atrial Fibrillation Detection

scholarly journals TIMING AND YIELD OF ATRIAL FIBRILLATION DETECTION BY IMPLANTABLE LOOP RECORDERS IN EMBOLIC STROKE OF UNDETERMINED SOURCE

2020 ◽  
Vol 75 (11) ◽  
pp. 445
Author(s):  
Courtney Campbell ◽  
Beth Foreman ◽  
Daniel L. Sosh ◽  
Rebecca Carter ◽  
Vivien H. Lee ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Embolic Stroke ◽  
Implantable Loop Recorders ◽  
Atrial Fibrillation Detection
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