rate of atrial fibrillation through 12 months in patients with recent ischemic stroke of presumed known origin

Conditions: Stroke, Acute

Summary: the purpose of the stroke af study is to compare the incidence of atrial fibrillation (af) through 12 months between continuous cardiac rhythm monitoring with the reveal linq™ insertable cardiac monitor (icm) (continuous monitoring arm) and standard of care (soc) medical treatment (control arm) in subjects with a recent ischemic stroke of presumed known origin.

stroke af is a prospective, multi-site, randomized, controlled, non-blinded, post-market study. the stroke af study will compare the incidence rate of atrial fibrillation through 12 months between the continuous monitoring arm and the control arm in subjects with a recent ischemic stroke of presumed known origin. subjects randomized to the continuous monitoring arm will have a reveal linq insertable cardiac monitor inserted within 10 days of the qualifying stroke and undergo continuous remote monitoring. subjects randomized to the control arm will be followed per site specific standard of care.

Eligibility criteria:
inclusion criteria: * subject has had an ischemic stroke believed to be due to small vessel disease, large vessel cervical or intracranial atherosclerosis within the past 10 days * subject is willing and able to undergo study requirements and expected to be geographically stable during study follow-up * subject is 60 years of age or older, or age 50 to 59 years plus a documented medical history of at least one of the following additional risk factors for stroke: * congestive heart failure * hypertension (systolic blood pressure \> 140) * diabetes mellitus * prior stroke (\>90 days ago, other than study qualifying index event) * vascular disease (e.g. coronary artery disease, heart attack, peripheral artery disease and complex aortic plaque) exclusion criteria: * subject has had a cryptogenic stroke * subject has had a cardioembolic stroke * subject has untreated hyperthyroidism * subject has had a recent myocardial infarction \<1 month of stroke * subject has had a recent cardiac surgery (e.g. coronary artery bypass surgery (cabg)) \<1 month of stroke * subject has a mechanical heart valve * subject has valvular disease requiring immediate surgical intervention * subject has documented prior history of atrial fibrillation or atrial flutter * subject has permanent indication for oral anticoagulation * subject has permanent contraindication to oral anticoagulation such that detection of af would not change medical management, based on enrolling investigators judgment * subject is enrolled in a concurrent study that may confound the results of this study. co-enrollment in any concurrent clinical study (including registries) requires approval of the study manager or designee. * subject's life expectancy is less than 1 year * subject is pregnant * subject has or is indicated for implant with a pacemaker, implantable cardioverter defibrillator (icd), cardiac resynchronizationtherapy (crt), or an implantable hemodynamic monitor * subject with a medical condition that precludes the patient from participation in the opinion of the investigator