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Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
28:13

Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation

Published on: February 26, 2013

Unexpected low prevalence of atrial fibrillation in cryptogenic ischemic stroke: a prospective study

Fanny Dion1, Denis Saudeau, Isabelle Bonnaud

  • 1Service de Cardiologie B, pôle Coeur, Thorax, Vaisseaux, hôpital Trousseau, Tours University, CHRU de Tours, 37044, Tours Cedex 9, France.

Journal of Interventional Cardiac Electrophysiology : an International Journal of Arrhythmias and Pacing
|May 11, 2010
PubMed

Insights

Continuous monitoring did not reveal significant atrial fibrillation in cryptogenic stroke patients under 75. Atrial vulnerability assessment also failed to predict spontaneous arrhythmias, suggesting limited utility of these methods in this population.

Area of Science:

  • Cardiology
  • Neurology
  • Electrophysiology

Background:

  • Ischemic stroke has high recurrence rates and mortality.
  • Determining stroke etiology is crucial for prognosis and management.
  • Atrial fibrillation is a suspected but often underdiagnosed cause of cryptogenic stroke.

Purpose of the Study:

  • To determine the incidence of atrial fibrillation in cryptogenic ischemic stroke using long-term heart rate monitoring.
  • To assess the predictive value of atrial vulnerability testing for spontaneous atrial fibrillation.

Main Methods:

  • Prospective enrollment of 24 patients (<75 years) with cryptogenic stroke.
  • Exclusion of other stroke causes via ECG, Holter, echocardiography, Doppler, and lab tests.
  • Electrophysiological study and implantable loop recorder implantation for monitoring.

Main Results:

  • 37.5% showed latent atrial vulnerability; 33.3% had inducible sustained arrhythmia.
  • No sustained atrial fibrillation or significant episodes were detected by implantable loop recorders over 14.5 months.
  • One patient experienced non-significant atrial fibrillation episodes.

Conclusions:

  • Implantable loop recorders did not demonstrate symptomatic atrial fibrillation in this patient group.
  • Routine use of implantable loop recorders is not recommended for all cryptogenic stroke evaluations.
  • Atrial vulnerability assessment is not a reliable predictor of spontaneous arrhythmia in cryptogenic stroke.
Abstract

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