492 EMBOLIC STROKE OF UNDETERMINED SOURCE: ROLE OF IMPLANTABLE LOOP RECORDER IN ASYMPTOMATIC ATRIAL FIBRILLATION DETECTION AND SECONDARY PREVENTION OF NEW EMBOLIC EVENTS

Abstract Background and Aims AF (Atrial Fibrillation) is the most important cause of Embolic Stroke Undetermined Source (ESUS). Implantable Loop Recorder (ILR) demonstrated highest sensitivity for detecting post-stroke asymptomatic AF. This register was created to assess prevalence episodes in patients after ESUS verify possible benefits on clinical outcomes such as TIA or stroke recurrence death using ILR. Methods 278 admitted Unit “Città della Salute e Scienza” hospital Torino between 2011 2019, underwent ILR implantation if they had at least one risk factor including obesity, hyperthyroidism, atrial enlargement transthoracic echocardiography, severe mitral valve disease, CHADS-VASc score ≥ 4, age > 70 years old diabetes. The control group composed 165 other departments same diagnosed with ESUS, not implanted We used propensity matching select 132 from each (matching age, sex, CHADS-VASc, HAS-BLED baseline characteristics). Risk protective factors were estimated (deaths recurrence) evaluated logistic regression univariate multivariate analyses. Results detection rate longer than 5 minutes significantly higher (41.7% vs 15.9%, p<0.001). On analysis, we found a trend towards role composite outcome mortality (OR 0.52, CI 0.26–1.04, p 0.06). terms deaths 0.4, 0.17–0.94, 0.03) ischemic event recurrences 0.41, 0.19–0.87, 0.02). Age consistently identified all outcomes. Conclusion In AF, are 41.7% cases thanks Our study that policy also gives benefit death, although limited size population presence selection bias may limit generalisation our results.