Age-Dependent Detection of Atrial Fibrillation with Implantable Cardiac Monitors in Patients with Cryptogenic Stroke

• Published in: TH open : companion journal to thrombosis and haemostasis 2024-04, Vol.8 (2), p.e202-e208
• Main Authors: Uhe, Tobias, Keilitz, Janina, Berrouschot, Jörg, Wachter, Rolf
• Format: Article
• Language: English
• Subjects: atrial fibrillation; cryptogenic stroke; implantable cardiac monitors; Original
• ISSN: 2512-9465; 2567-3459; 2512-9465
• DOI: 10.1055/s-0044-1786015

Continuous monitoring using implantable cardiac monitors (ICMs) results in atrial fibrillation (AF) detection rates of up to 30% in patients with cryptogenic stroke (CS). Although higher age is an independent risk factor for AF, there are no age-specific recommendations for the implantation of ICM.  The aim of this study was to analyze age-related AF rates in patients with CS and continuous rhythm monitoring, to determine the rates of oral anticoagulation (OAC) and recurrent cerebrovascular events (stroke or transient ischemic attack) in patients with ICM-detected AF, and to describe the temporal relationship of AF detection and recurrent cerebrovascular events.  In this observational study, patients with CS provided with ICMs were systematically followed. All patients underwent 72-hour electrocardiography monitoring, transcranial Doppler ultrasound, and transthoracic echocardiography prior to ICM insertion. Follow-up included a regular outpatient presentation every 3 months with medical history, physical examination, and interrogation of the ICM.  One-hundred eighty-six patients (mean age: 65 ± 12 years, 54% female) were included in this analysis. AF was detected in 6, 27, 56, and 65% (