PO-03-048 CLINICAL UTILITY OF IMPLANTABLE LOOP RECORDERS AFTER CRYPTOGENIC STROKE: INSIGHTS FROM A LARGE ACADEMIC STROKE CENTER

نویسندگان

چکیده

Detection of occult AF using implantable loop recorders (ILR) has become routine practice in the evaluation cryptogenic stroke, yet there are few data demonstrating that ILRs reduce risk recurrent stroke. Our aim was to determine if diagnostic yield for ILR-detected patients with stroke may be improved clinical characteristics, and ILR-directed changes medical therapy We observed 282 consecutive (n=255) or transient ischemic attack (TIA, n=27) implanted ILR at an academic center outcomes first detected AF, TIA, temporal relation between stroke/TIA. Collected included demographics, comorbid conditions, imaging details, ECG echocardiographic findings, laboratory testing. During 557 days median follow-up, 50 (18%) manifested after a 107 days, including 15% 1 year, 20% 2 years, 23% 3 years. All but patient were started on direct anticoagulant (n=48) warfarin (n=1) upon diagnosis. Age (HR 1.04 per 95% CI 1.02-1.07; p<0.001) middle cerebral artery 2.20, 1.06-4.58; p=0.035) independently associated shorter time AF. Only 20 (n=17) TIA (n=3) had AF; both cases seen >1 year despite continuous monitoring. 65-years old best delineated (area under ROC curve 0.66, p<0.001). Among 157 <65 years old, only 13 (8%) all left ventricular end-diastolic dimension >4.60 cm (median LVEDD 4.90) cortical 125 ≥65 37 (30%) mitral regurgitation 1.98, 1.06-3.72; p=0.03) detection. is highest within Consideration age, territory, valvular disease increases specificity detecting thus informs who should receive ILR. Correlation poor, raising concern use not prevent additional strokes.

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ژورنال

عنوان ژورنال: Heart Rhythm

سال: 2023

ISSN: ['1556-3871', '1547-5271']

DOI: https://doi.org/10.1016/j.hrthm.2023.03.1051