Differences in Inpatient Insertable Cardiac Monitor Placement after Ischemic Stroke

Yaghi, Shadi; Furie, Karen L.; Wechsler, Lawrence R.; Mullen, Michael T.; Stretz, Christoph; Burton, Tina; Havenon, Adam de

doi:10.1016/j.jstrokecerebrovasdis.2021.106124

Cited by 2 publications

(2 citation statements)

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“…9,16 The intensity of cardiac monitoring varies depending on local availability, cost, and stroke physicians’ preferences. 17–20 Most clinical guidelines recommend at least 24 hours of cardiac monitoring 21–24 suggesting longer-term monitoring for selected patients with ESUS but without recommending a specific duration. 21–23…”

Section: Cardiac Monitoring To Detect Af After Ischemic Strokementioning

confidence: 99%

“…9,16 The intensity of cardiac monitoring varies depending on local availability, cost, and stroke physicians' preferences. [17][18][19][20] Most clinical guidelines recommend at least 24 hours of cardiac monitoring [21][22][23][24] suggesting longerterm monitoring for selected patients with ESUS but without recommending a specific duration. [21][22][23] The main question that remains unanswered regarding AF screening poststroke is whether a longer duration of monitoring reduces the risk of stroke recurrence and other vascular events (eg, decompensated heart failure, decompensated AF, and acute myocardial infarction).…”

Section: Cardiac Monitoring To Detect Af After Ischemic Strokementioning

confidence: 99%

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Atrial Fibrillation Detection and Load: Knowledge Gaps Related to Stroke Prevention

Smith,

Yaghi,

Sposato

et al. 2024

Stroke

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Atrial fibrillation is a major cause of ischemic stroke. Technological advances now support prolonged cardiac rhythm monitoring using either surface electrodes or insertable cardiac monitors. Four major randomized controlled trials show that prolonged cardiac monitoring detects subclinical paroxysmal atrial fibrillation in 9% to 16% of patients with ischemic stroke, including in patients with potential alternative causes such as large artery disease or small vessel occlusion; however, the optimal monitoring strategy, including the target patient population and the monitoring device (whether to use an event monitor, insertable cardiac monitor, or stepped approach) has not been well defined. Furthermore, the clinical significance of very short duration paroxysmal atrial fibrillation remains controversial. The relevance of the duration of monitoring, burden of device-detected atrial fibrillation, and its proximity to the acute ischemic stroke will require more research to define the most effective methods for stroke prevention in this patient population.

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