Cryptogenic stroke and atrial fibrillation in a real-world population: the role of insertable cardiac monitors.
Aged
Anticoagulants
/ therapeutic use
Atrial Fibrillation
/ complications
Electrocardiography, Ambulatory
Female
Follow-Up Studies
Humans
Kaplan-Meier Estimate
Male
Monitoring, Physiologic
/ instrumentation
Prosthesis Implantation
Risk Factors
Severity of Illness Index
Stroke
/ complications
Treatment Outcome
Journal
Scientific reports
ISSN: 2045-2322
Titre abrégé: Sci Rep
Pays: England
ID NLM: 101563288
Informations de publication
Date de publication:
24 02 2020
24 02 2020
Historique:
received:
30
08
2019
accepted:
24
01
2020
entrez:
26
2
2020
pubmed:
26
2
2020
medline:
13
11
2020
Statut:
epublish
Résumé
The incidence of atrial fibrillation (AF) in cryptogenic stroke (CS) patients has been studied in carefully controlled clinical trials, but real-world data are limited. We investigated the incidence of AF in clinical practice among CS patients with an insertable cardiac monitor (ICM) placed for AF detection. Patients with CS admitted to our Stroke Unit were included in the study; they received an ICM and were monitored for up to 3 years for AF detection. All detected AF episodes of at least 120 sec were considered. From March 2016 to March 2019, 58 patients (mean age 68.1 ± 9.3 years, 67% male) received an ICM to detect AF after a CS. No patients were lost to follow-up. AF was detected in 24 patients (41%, AF group mean age 70.8 ± 9.4 years, 62% male) after a mean time of 6 months from ICM (ranging from 2 days to 2 years) and 8 months after CS (ranging from 1 month to 2 years). In these AF patients, anticoagulant treatment was prescribed and nobody had a further stroke. In conclusion, AF episodes were detected via continuous monitoring with ICMs in 41% of implanted CS patients. AF in CS patients is asymptomatic and difficult to diagnose by strategies based on intermittent short-term recordings. Therefore, we suggest that ICMs should be part of daily practice in the evaluation of CS patients.
Identifiants
pubmed: 32094376
doi: 10.1038/s41598-020-60180-6
pii: 10.1038/s41598-020-60180-6
pmc: PMC7040015
doi:
Substances chimiques
Anticoagulants
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
3230Références
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