Early atrial fibrillation detection is associated with higher arrhythmic burden in patients with loop recorder after...

Area of Science:

• Cardiology
• Neurology
• Medical Devices

Background:

• Long-term monitoring for atrial fibrillation (AF) is recommended post-embolic stroke of undetermined source (ESUS) to initiate anticoagulation.
• Limited data exists on AF burden following ESUS, impacting clinical management and therapeutic strategies.
• Subclinical AF detection is crucial for stroke management.

Purpose of the Study:

• To investigate the association between early AF detection (within 90 days of implantable loop recorder (ILR) implantation) and AF burden in ESUS patients.
• To evaluate the clinical implications of AF burden in ESUS patients.
• To determine the optimal timing for AF detection and subsequent treatment initiation.

Main Methods:

• Retrospective single-center study involving 129 ESUS patients who received ILRs.
• Analysis of AF detection timing and AF burden.
• Comparison of patient characteristics between AF and non-AF groups.

Main Results:

• Atrial fibrillation was detected in 40.3% of patients.
• Patients with AF were older, had higher CHAD2S2-Vasc scores, and larger left atrial volumes.
• Early AF detection (within 90 days) was significantly associated with a higher AF burden (>1%), with an odds ratio of 20.0.

Conclusions:

• Early detection of AF following ESUS is significantly associated with a higher AF burden.
• This finding supports the importance of early and continuous monitoring for AF in ESUS patients.
• Timely AF detection can inform therapeutic strategies and improve patient outcomes.