Differences in ECG- vs. proLonged cardIac MonItor-DeTected Atrial Fibrillation in STROKE Patients (DELIMIT AF-STROKE)

Study Overview
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Brief Summary
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The present study is an investigator-initiated, single-center, retrospective study based on data from the London Ontario Stroke Registry (LOSR), aiming to compare the characteristics and outcomes of ECG-detected and Device-Detected atrial fibrillation in patients with ischemic stroke and transient ischemic attack.

Detailed Description
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Patients with ischemic stroke and transient ischemic attack (TIA) without known atrial fibrillation (AF) are investigated with Prolonged Cardiac Monitoring (PCM) to detect AF. It is unclear if AF detected on 12-lead ECG after stroke occurrence bears the same risk of stroke as Device-detected AF. The investigators hypothesize, that Device-detected AF has a lower risk of ischemic stroke recurrence. The investigators will conduct a retrospective analysis of prospectively collected data from consecutive patients enrolled in the London Ontario Stroke Registry, (Ontario, Canada). The primary outcome will be a recurrent ischemic stroke at the end of the available follow-up window. The investigators will include ischemic stroke and TIA patients with ECG-detected AF and those with Device-detected AF on at least 7 days of Holter monitoring.

Official Title
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Differences in ECG- vs. proLonged cardIac MonItor-DeTected Atrial Fibrillation in STROKE Patients

Conditions
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TIA, Stroke, Atrial Fibrillation

Intervention / Treatment
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* Diagnostic Test: Prolonged cardiac monitoring
* Diagnostic Test: ECG


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age ≥18 years Patient with a diagnosis of ischemic stroke or TIA. ECG-diagnosed AF or PCM-detected AF post ischemic stroke or TIA Exclusion Criteria: Individuals younger than18 years-old Patients without IS or TIA diagnosis

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| ECG-Detected AF<br>Patients with atrial fibrillation detected on 12-lead ECGs done post-stroke | Diagnostic Test: ECG<br>* Electrocardiogram<br>|
| Device-Detected AF<br>Patients with atrial fibrillation detected on prolonged Holter monitoring lasting at least 7 days. | Diagnostic Test: Prolonged cardiac monitoring<br>* Prolonged cardiac monitoring<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of Participants with Recurrent Ischemic Stroke at End of available Follow-up Time | Documented recurrent ischemic stroke | Duration of follow-up - minimum of 3 months after the first encounter with the stroke team | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Death | Number of patients dead at the end of the available follow-up | Duration of follow-up - minimum of 3 months after the first encounter with the stroke team | 
| Readmission for decompensated AF or heart failure | Prevalence of readmission for decompensated AF or heart failure (HF) in each group | Duration of follow-up - minimum of 3 months after the first encounter with the stroke team | 
| Prevalence of risk factors, cardiovascular comorbidities, and structural heart disease | Proportion with vascular risk factors, cardiovascular comorbidities, and structural heart disease in each group | Documented at baseline. |