scholarly journals Atrial fibrillation and treatment changes in cryptogenic stroke patients with an implantable loop recorder for continuous cardiac rhythm monitoring

2013 ◽  
Vol 34 (suppl 1) ◽  
pp. P387-P387 ◽  
Author(s):  
A. Ungar ◽  
G. Rieger ◽  
T. West ◽  
H. Purerfellner ◽  
J. Bucx ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Cardiac Rhythm ◽  
Cryptogenic Stroke ◽  
Implantable Loop Recorder ◽  
Stroke Patients ◽  
Loop Recorder ◽  
Treatment Changes ◽  
Rhythm Monitoring

Abstract 25: Paroxysmal Atrial Fibrillation is Common in Patients With Defined Etiology for Stroke: Prolonged Monitoring of Cardiac Rhythm for Detection of Atrial Fibrillation After a Cerebral Ischemic Event (PEAACE) Study

Stroke ◽  
2014 ◽  
Vol 45 (suppl_1) ◽  
Author(s):  
Esseddeeg M Ghrooda ◽  
Peter Dobrowolski ◽  
Ghazala Basir ◽  
Ibrahim Yaseen ◽  
Nazim khan ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Ischemic Stroke ◽  
Cardiac Rhythm ◽  
Previous History ◽  
Cryptogenic Stroke ◽  
Predictive Score ◽  
Stroke Patients ◽  
Similar Frequency ◽  
Stroke Team ◽  
Rhythm Monitoring

Introduction: Atrial fibrillation (AF) related cardioembolic stroke accounts for over 20% of ischemic stroke. Recent reports using prolonged cardiac rhythm monitoring (PCRM) in cryptogenic stroke reveal paroxysmal AF (PAF) in an additional 20% of patients. We report our findings with PCRM in patients with and without cryptogenic stroke patients in whom an initial 24-h Holter was negative. Methods: Patients admitted to the stroke service with no previous history of AF and no AF on Holter monitoring were enrolled for 3 weeks of PCRM. We used a PAF predictive score to determine the risk of the arrhythmia. All studies were interpreted by the stroke team prior to final review by the cardiologist. Results: Between Sept 2012 and June 2013, 96 patients were evaluated. Over all PAF was diagnoses in 37.5 % of patients. PAF was diagnosed in 32% of patients with cryptogenic stroke and 36 % of patients where an additional etiology may account for the stroke diagnosis. The AF prediction score was not useful in the recognition of patients that were more likely to be at risk for AF. 96 of 98 recordings were correctly identified by the stroke team prior to final diagnosis by the cardiologist. Interpretation: PAF is more common in stroke patients than was previously suspected. It occurs with similar frequency in patients with and without cryptogenic stroke. Our data strongly supports the need for prolonged cardiac rhythm monitoring in all stroke patients to diagnose this important preventable cause of ischemic stroke.

scholarly journals Presence of Atrial Fibrillation in Stroke Patients With Patent Foramen Ovale: Systematic Review and Meta-Analysis

2021 ◽  
Vol 12 ◽  
Author(s):  
Jessie Ze-Jun Chen ◽  
Vincent N. Thijs
Keyword(s):  
Atrial Fibrillation ◽  
Ischemic Stroke ◽  
Confidence Interval ◽  
Lower Risk ◽  
Patent Foramen Ovale ◽  
Cryptogenic Stroke ◽  
Foramen Ovale ◽  
Stroke Patients ◽  
Loop Recorder ◽  
Cross Sectional

Purpose: Patent foramen ovale (PFO) is associated with ischemic stroke, especially in patients with embolic stroke of undetermined source. This study aims to evaluate the presence of atrial fibrillation (AF) in ischemic stroke patients with PFO.Methods: We systematically searched EMBASE and MEDLINE databases on May 21, 2020 for studies that analyzed the presence of AF in patients with PFO. The primary outcome was the presence of AF in patients with PFO compared with those without. Outcomes were pooled using a random-effects model using the method of DerSimonian and Laird. We recorded demographic characteristics and the methods used for AF detection in the studies included (unspecified, history/medical records review, ECG, Holter monitor, or loop recorder).Results: A total of 14 studies and 13,245 patients fulfilled the entry criteria. The average age was 61.2 years and 41.3% of the participants were female. There was a lower risk of AF in patients with PFO compared with those without (RR 0.52, 95% confidence interval, 0.41–0.63, p < 0.001). There was no evidence of heterogeneity. The lower risk of AF was found in cross-sectional and longitudinal studies and in studies stratified by average age (<60 or ≥60) and in cryptogenic stroke. Meta-regression by PFO detection technique suggested that studies using transoesophageal echocardiogram for PFO detection reported higher risk of AF (1.39, 95% confidence interval 1.14–1.70, p = 0.004).Conclusion: The presence of a PFO in patients with ischemic stroke/TIA may be associated with a lower risk of AF. Few studies have estimated the risk of future AF in patients with PFO.

scholarly journals Mobile Cardiac Outpatient Telemetry Patch vs Implantable Loop Recorder in Cryptogenic Stroke Patients in the US – Cost-Minimization Model

2021 ◽  
Vol Volume 14 ◽  
pp. 445-458
Author(s):  
Goran Medic ◽  
Nikos Kotsopoulos ◽  
Mark P Connolly ◽  
Jennifer Lavelle ◽  
Vincent Norlock ◽  
...  
Keyword(s):  
Cost Minimization ◽  
Cryptogenic Stroke ◽  
Implantable Loop Recorder ◽  
Stroke Patients ◽  
Loop Recorder ◽  
The Us

Missing LINQ: extrusion of a new-generation implantable loop recorder in a child

2016 ◽  
Vol 26 (7) ◽  
pp. 1445-1447 ◽  
Author(s):  
Ahmad S. Chaouki ◽  
Richard J. Czosek ◽  
David S. Spar
Keyword(s):  
Cardiac Rhythm ◽  
Paediatric Population ◽  
Implantable Loop Recorder ◽  
Loop Recorder ◽  
New Models ◽  
Implantable Loop Recorders ◽  
New Generation ◽  
Rhythm Monitoring

AbstractCardiac rhythm monitoring has been facilitated by the use of implantable loop recorders. New models of these devices are 87% smaller than before allowing for easier implantation and use in the paediatric population. Recommendations are for closure with adhesive. We report a device extrusion in a 6-year-old patient. Based on this, our practice has changed to include subcutaneous sutures this complication.

scholarly journals Blood Biomarkers of Heart Failure and Hypercoagulation to Identify Atrial Fibrillation–Related Stroke

Stroke ◽  
2019 ◽  
Vol 50 (8) ◽  
pp. 2223-2226 ◽  
Author(s):  
Markus Kneihsl ◽  
Thomas Gattringer ◽  
Egbert Bisping ◽  
Daniel Scherr ◽  
Reinhard Raggam ◽  
...  
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Cardiac Rhythm ◽  
Blood Biomarkers ◽  
Stroke Patients ◽  
At Iii ◽  
D Dimer ◽  
Rhythm Monitoring

Background and Purpose— Occult atrial fibrillation (AF) causes a relevant proportion of initially cryptogenic stroke (CS), but prolonged rhythm monitoring is difficult to apply to all such patients. We hypothesized that blood biomarkers indicating heart failure (NT-proBNP [N-terminal pro-brain natriuretic peptide]) and hypercoagulability (D-dimer, AT-III [antithrombin-III]) were associated with AF-related stroke and could serve to predict the likelihood of AF detection in CS patients early on. Methods— Over a 1-year period, we prospectively applied a defined etiologic work-up to all ischemic stroke patients admitted to our stroke unit. If no clear stroke cause was detected (CS), patients underwent extended in-hospital cardiac rhythm monitoring (≥72 hours). Blood to determine biomarker levels was drawn within 24 hours after admission. Results— Of 429 patients, 103 had AF-related stroke. Compared with noncardiac stroke patients (n=171), they had higher NT-proBNP (1867 versus 263 pg/ml) and D-dimer levels (1.1 versus 0.6 µg/ml), and lower AT-III concentration (89% versus 94%). NT-proBNP ≥505 pg/ml distinguished AF-related from noncardiac stroke with a sensitivity of 93% and a specificity of 72%. D-dimer and AT-III cutoffs had lower sensitivities (61% and 53%) and specificities (58% and 69%) for AF-related stroke. Of all initially 143 CS patients, 14 were diagnosed with AF during in-hospital monitoring. The preidentified NT-proBNP cutoff ≥505 pg/ml correctly predicted AF in 12 of them (86%, negative predictive value: 98%), while D-dimer and AT-III cutoffs were noncontributory. Conclusions— This study supports the association of NT-proBNP and to a lesser extent of hypercoagulation markers with AF-related stroke. NT-proBNP seems helpful in selecting CS patients for immediate extended cardiac rhythm monitoring to detect occult AF whereby levels <505 pg/ml seem to have a high-negative predictive value.

Sign in / Sign up

Export Citation Format

Share Document