Abstract 14805: Use of Dedicated Protocol and Implantable Loop Recorder to Evaluate for Atrial Fibrillation in Cryptogenic Stroke Patients: Real World Validation of Crystal AF
Introduction: Embolic strokes related to atrial fibrillation (AF) carry significant morbidity and mortality. Identifying patients with asymptomatic AF following stroke is difficult. A protocol for incorporation of implantable loop recorders (ILR) in stroke management has not been established.
Methods: We developed a protocol for evaluation of patients with cryptogenic embolic stroke using ILR for detection of AF (figure 1). Patients implanted with ILR were enrolled in an AF clinic with structured remote follow-up. The primary end point was time to first detected AF. Secondary end point was time to initiation of anticoagulation following identification of AF.
Results: 95 patients underwent ILR placement. Baseline characteristics are shown in table 1.
The median time between stroke and ILR placement was 6 days with a range of 1 to 496 days. The mean follow-up time was 169.4 +/- 103.1days. 18 patients (18.9%) had AF detected during the study period (Figure 2). Mean time to detection of AF was 95.7 +/- 93.6 days. 94.4% were anticoagulated (52.9% Rivaroxaban, 41.2% Apixaban, 5.9% Warfarin). The median time from detection of AF to initiation of anticoagulation was 2 days with a range of 1 to 28 days.
Conclusions: A protocol for incorporating ILR in evaluation of embolic cryptogenic stroke can improve AF detection and time to initiation of anticoagulation.
Author Disclosures: A. Seiler: Speakers Bureau; Modest; Medtronic. S. Biby: None. P. Sethi: None. J. Allred: Honoraria; Modest; Medtronic.
- © 2015 by American Heart Association, Inc.