Cost-effectiveness of an insertable cardiac monitor to detect atrial fibrillation in patients with cryptogenic stroke

Abstract

Insertable cardiac monitors are a cost-effective diagnostic tool for the prevention of recurrent stroke in patients with cryptogenic stroke. The cost-effectiveness results have relevance for the UK and across value-based healthcare systems that assess costs relative to outcomes.

Plasma D‐dimer levels and ischaemic lesions in multiple vascular regions can predict occult cancer in patients with cryptogenic stroke

“…However, in some patients, the hypercoagulable state associated with occult cancer underlies the cause of cryptogenic stroke. Occult cancer is one of the uncommon causes of stroke and should not be missed in the evaluation of cryptogenic stroke . Our findings support the notion that cryptogenic stroke has a distinctive pathology.…”

Refinement of detecting atrial fibrillation in stroke patients: results from the TRACK‐AF Study

“…Implantation of the ICM in patients with cryptogenic stroke is cost effective because it prevents recurrent strokes by anticoagulation compared to standard workup . In our study at least 25% of patients with cryptogenic stroke have an SRA level of 0 and will hardly benefit from ICM implantation.…”

Newer technologies for detection of atrial fibrillation

“…Also, it was shown to detect more atrial fibrillation than seven day Holter monitoring in a prospective cohort study of patients with cryptogenic stroke 56. Although a modeled cost effective analysis predicted that using ILR monitoring after cryptogenic stroke and subsequent anticoagulation treatment in patients identified as having atrial fibrillation were cost effective,112 this analysis has certain limitations similar to the cost effective analyses of standalone handheld and smartphone based electrocardiography recording devices. Also, which groups of patients, if any, should be monitored by ILR early after stroke and TIA or after negative prolonged monitoring by non-invasive methods remains largely unknown.…”