When each device is compared incrementally , BioMonitor 2-AF dominates Reveal LINQ and Confirm RX .
BACKGROUND Cryptogenic stroke is a stroke for which no cause is identified after st and ard diagnostic tests .
Long-term implantable cardiac monitors may be better at diagnosing atrial fibrillation and provide an opportunity to reduce the risk of stroke recurrence with anticoagulants .
OBJECTIVES The objectives were to assess the diagnostic test accuracy , clinical effectiveness and cost-effectiveness of three implantable monitors [ BioMonitor 2-AF ™ ( Biotronik SE & Co. KG , Berlin , Germany ) , Confirm Rx ™ ( Abbott Laboratories , Lake Bluff , IL , USA ) and Reveal LINQ ™ ( Medtronic plc , Minneapolis , MN , USA ) ] in patients who have had a cryptogenic stroke and for whom no atrial fibrillation is detected after 24 hours of external electrocardiographic monitoring .
Prevalence and Risk Factors for Paroxysmal Atrial Fibrillation and Flutter Detection after Cryptogenic Ischemic Stroke.
INTRODUCTION Long-term cardiac monitoring with implantable loop recorders ( ILRs ) has revealed occult paroxysmal atrial fibrillation and flutter ( PAF ) in a substantial minority of cryptogenic ischemic stroke ( CIS ) patients . Herein , we aim to define the prevalence , clinical relevance , and risk factors for PAF detection following early poststroke ILR implantation . MATERIAL S AND METHODS A retrospective study of CIS patients ( n = 100 , mean age 65.8 years ; 52.5 % female ) who underwent ILR insertion during , or soon after , index stroke admission . Patients were prospect ively followed by the study cardiac electrophysiologist who confirmed the PAF diagnosis . Univariate and multivariate analyses compared clinical , laboratory , cardiac , and imaging variables between PAF patients and non-PAF patients . RESULTS PAF was detected in 31 of 100 ( 31 % ) CIS patients , and anticoagulation was initiated in almost all ( 30 of 31 , 96.8 % ) . Factors associated with PAF detection include older age ( mean [ year ] 72.9 versus 62.9 ; P = .003 ) , white race ( odds ratio [ OR ] , 4.5 ; confidence interval [ CI ] , 1.8 - 10.8 ; P = .001 ) , prolonged PR interval ( PR > 175 ms ; OR , 3.3 ; CI , 1.2 - 9.4 ; P = .022 ) , larger left atrial ( LA ) diameter ( mean [ cm ] 3.7 versus 3.5 ; P = .044 ) and LA volume index ( mean [ cc/m2 ] ; 30.6 versus 24.2 ; P = .014 ) , and lower hemoglobin (Hb)A1c ( mean [ % ] 6.0 versus 6.4 ; P = .036 ) . Controlling for age , obesity ( body mass index > 30 kg/m2 ; OR , 1.2 ; CI , 1.1 - 1.4 ; P = .033 ) was independently associated with PAF detection . DISCUSSION PAF was detected with high prevalence following early postcryptogenic stroke ILR implantation and result ed in significant management changes . Older age , increased PR interval , LA enlargement , and lower HbA1c are significantly associated with PAF detection . Controlling for age , obesity is an independent risk factor . A larger prospect i ve study is warranted to confirm these findings
When each device is compared incrementally , BioMonitor 2-AF dominates Reveal LINQ and Confirm RX .
BACKGROUND Cryptogenic stroke is a stroke for which no cause is identified after st and ard diagnostic tests .
Long-term implantable cardiac monitors may be better at diagnosing atrial fibrillation and provide an opportunity to reduce the risk of stroke recurrence with anticoagulants .
OBJECTIVES The objectives were to assess the diagnostic test accuracy , clinical effectiveness and cost-effectiveness of three implantable monitors [ BioMonitor 2-AF ™ ( Biotronik SE & Co. KG , Berlin , Germany ) , Confirm Rx ™ ( Abbott Laboratories , Lake Bluff , IL , USA ) and Reveal LINQ ™ ( Medtronic plc , Minneapolis , MN , USA ) ] in patients who have had a cryptogenic stroke and for whom no atrial fibrillation is detected after 24 hours of external electrocardiographic monitoring .