scholarly journals Targeted Anticoagulation for Atrial Fibrillation Guided by Continuous Rhythm Assessment With an Insertable Cardiac Monitor: The Rhythm Evaluation for Anticoagulation With Continuous Monitoring (REACT.COM) Pilot Study

2015 ◽  
Vol 27 (3) ◽  
pp. 264-270 ◽  
Author(s):  
ROD PASSMAN ◽  
PETER LEONG-SIT ◽  
ADIN-CRISTIAN ANDREI ◽  
ANNA HUSKIN ◽  
TODD T. TOMSON ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Pilot Study ◽  
Continuous Monitoring ◽  
Cardiac Monitor ◽  
Insertable Cardiac Monitor

012 Cost-effectiveness of long-term continuous monitoring with an insertable cardiac monitor to detect atrial fibrillation in patients with cryptogenic stroke: an australian payer perspective

2018 ◽  
Vol 89 (6) ◽  
pp. A6.2-A6 ◽  
Author(s):  
Vincent Thijs ◽  
Carmel Guarnieri ◽  
Koji Makino ◽  
Dominic Tilden ◽  
Marianne Huynh
Keyword(s):  
Atrial Fibrillation ◽  
Oral Anticoagulation ◽  
Continuous Monitoring ◽  
Recurrent Stroke ◽  
Cryptogenic Stroke ◽  
Cost Effective ◽  
Cardiac Monitor ◽  
Payer Perspective ◽  
Insertable Cardiac Monitor

IntroductionDetection of atrial fibrillation (AF) is required to initiate oral anticoagulation (OAC) after cryptogenic stroke. However, paroxysmal AF can be difficult to diagnose with short term cardiac monitoring. Taking an Australian payer perspective, we evaluated whether long-term continuous monitoring with an insertable cardiac monitor (ICM) is cost-effective for preventing recurrent stroke in patients with cryptogenic stroke.MethodsA lifetime Markov model was developed to simulate the follow-up of patients, comparing long-term continuous monitoring with an ICM to monitoring by conventional care. We used a linked evidence approach to estimate the rates of recurrent stroke when AF detection leads to initiation of oral anticoagulation, as detected using ICM during the lifetime of the device, or as detected using usual care. All diagnostic and patient management costs were modelled. Other model inputs were determined by literature review. Probabilistic sensitivity analysis (PSA) was undertaken to explore the effect of parameter uncertainty according to CHADS2 score and oral anticoagulation treatment effect.ResultsIn the base-case analysis, the model predicted an incremental cost-effectiveness ratio (ICER) of A$29 570 per quality adjusted life year (QALY). Amongst CHADS2sub-groups analyses, the ICER ranged from A$26,342/QALY (CHADS2=6) to A$42,967/QALY (CHADS2=2). PSA suggested that the probabilities of ICM strategy being cost-effective were 53.4% and 78.7%, at thresholds of $30 000 (highly cost-effective) and $50 000 per QALY (cost-effective), respectively.ConclusionLong-term continuous monitoring with ICM is a cost-effective intervention to prevent recurrent stroke in patients following cryptogenic stroke in the Australian context.

A Novel Adaptive Insertable Cardiac Monitor Algorithm Improves the Detection of Atrial Fibrillation and Atrial Tachycardia in Silico

2021 ◽  
Author(s):  
Sunipa Saha ◽  
David Perschbacher ◽  
Paul Jones ◽  
Kate Frost ◽  
Arjun Sharma ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
In Silico ◽  
Atrial Tachycardia ◽  
Cardiac Monitor ◽  
Insertable Cardiac Monitor

Abstract 13915: Atrial Fibrillation Begets Atrial Fibrillation in Cryptogenic Stroke Patients: Results from the Crystal-AF Trial

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Rod S Passman ◽  
Jodi L Koehler ◽  
Paul D Ziegler
Keyword(s):  
Atrial Fibrillation ◽  
Cryptogenic Stroke ◽  
Secondary Stroke Prevention ◽  
Stroke Patients ◽  
Cardiac Monitor ◽  
Long Duration ◽  
Episode Duration ◽  
Duration Information ◽  
The Impact ◽  
Insertable Cardiac Monitor

Introduction: Initial episodes of atrial fibrillation (AF) detected following a cryptogenic stroke (CS) may be brief in duration and the clinical relevance of such episodes is uncertain. Hypothesis: We investigated whether an initial brief episode of AF was predictive of subsequent long duration AF episodes in CS patients (pts) with an insertable cardiac monitor (ICM). Methods: CS pts (n=208, age 61.6±11.3 years, 66% male) randomized to the ICM arm of the CRYSTAL-AF study and inserted with a device (Reveal® XT) were followed for 21±9 months. AF episodes (>30 seconds) were independently adjudicated and the first adjudicated AF episode was classified as brief (<1 hour) or long (≥1 hour). The incidence of subsequent long duration AF episodes among pts with an initially brief episode was computed. The impact of episode duration on prescription of oral anticoagulation (OAC) therapy was also assessed. Results: Among 36 pts with an adjudicated AF episode for which duration information was available, the initial episode was classified as brief in 18 (50%) pts and long in 18 (50%) pts. Among those with initially brief episodes, 10 (56%) experienced only subsequent brief episodes while 8 (44%) went on to experience at least one long AF episode. The median time between the initial brief episode and first long AF episode was 75 days [interquartile range: 27-624 days]. OAC was prescribed in 7/10 pts (70%) with only brief AF episodes compared to 26/26 pts (100%) with at least one long episode of AF (p=0.017). Conclusion: Initial AF episodes in pts with CS are equally likely to be of short or long duration. However, nearly half of CS pts with initially brief episodes of AF subsequently have long duration episodes detected much later via prolonged monitoring with ICMs. Therefore, early detection of brief AF episodes may merit more rigorous monitoring of AF with ICMs since physicians were significantly more likely to prescribe OAC for secondary stroke prevention in response to longer duration episodes.

Insertable cardiac monitor detection of silent atrial fibrillation in candidates for percutaneous patent foramen ovale closure

2019 ◽  
Vol 20 (5) ◽  
pp. 290-296 ◽  
Author(s):  
Paolo Scacciatella ◽  
Marcella Jorfida ◽  
Lorenza M. Biava ◽  
Ilaria Meynet ◽  
Domenica Zema ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Patent Foramen Ovale ◽  
Foramen Ovale ◽  
Cardiac Monitor ◽  
Insertable Cardiac Monitor

scholarly journals Detection of Subclinical Atrial Fibrillation in High-Risk Patients Using an Insertable Cardiac Monitor

2017 ◽  
Vol 3 (13) ◽  
pp. 1557-1564 ◽  
Author(s):  
Tine J. Philippsen ◽  
Lene S. Christensen ◽  
Michael G. Hansen ◽  
Jordi S. Dahl ◽  
Axel Brandes
Keyword(s):  
Atrial Fibrillation ◽  
High Risk ◽  
High Risk Patients ◽  
Cardiac Monitor ◽  
Risk Patients ◽  
Insertable Cardiac Monitor

scholarly journals Cost Effectiveness of Implantable Cardiac Monitor-Guided Intermittent Anticoagulation for Atrial Fibrillation: An Analysis of the REACT.COM Pilot Study

2016 ◽  
Vol 27 (11) ◽  
pp. 1304-1311 ◽  
Author(s):  
DANIEL A. STEINHAUS ◽  
PETER J. ZIMETBAUM ◽  
ROD S. PASSMAN ◽  
PETER LEONG-SIT ◽  
MATTHEW R. REYNOLDS
Keyword(s):  
Atrial Fibrillation ◽  
Cost Effectiveness ◽  
Pilot Study ◽  
Cardiac Monitor ◽  
Implantable Cardiac Monitor

scholarly journals TARGETED ANTICOAGULATION AS GUIDED BY AN INSERTABLE CARDIAC MONITOR AFTER PULMONARY VEIN ISOLATION FOR ATRIAL FIBRILLATION

2020 ◽  
Vol 75 (11) ◽  
pp. 512
Author(s):  
Christoff van Niekerk ◽  
David Yoo ◽  
Nicholas Olson ◽  
Katie Bordonaro
Keyword(s):  
Atrial Fibrillation ◽  
Pulmonary Vein ◽  
Pulmonary Vein Isolation ◽  
Cardiac Monitor ◽  
Insertable Cardiac Monitor
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