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Atrial Fibrillation Detection and Ischemic Stroke Recurrence in Cryptogenic Stroke: A Retrospective, Multicenter,

Kenichi Todo1, Shuhei Okazaki1, Ryosuke Doijiri2

  • 1Department of Neurology Osaka University Graduate School of Medicine Osaka Japan.

Journal of the American Heart Association
|January 19, 2024
PubMed

Insights

Detecting atrial fibrillation (AF) after cryptogenic stroke with an insertable cardiac monitor (ICM) did not increase stroke recurrence risk. Anticoagulation for detected AF was common and did not elevate risks in this patient group.

Area of Science:

  • Neurology
  • Cardiology
  • Medical Devices

Background:

  • Atrial fibrillation (AF) is a significant stroke risk factor.
  • The risk of recurrent stroke in patients with cryptogenic stroke and AF detected by insertable cardiac monitors (ICMs) requires further investigation.

Purpose of the Study:

  • To evaluate the risk of ischemic stroke recurrence in patients with cryptogenic stroke, comparing those with and without AF detected by ICMs.

Main Methods:

  • Retrospective review of 370 patients with cryptogenic stroke who underwent ICM implantation across 8 Japanese stroke centers.
  • Analysis using Cox regression models with landmark and time-dependent analyses.
  • Comparison of stroke recurrence rates between patients with and without ICM-detected AF.

Main Results:

  • Of 370 patients, 121 had AF detected; 110 received anticoagulation.
  • Ischemic stroke recurrence incidence was 4.0% in patients without AF and 5.8% in those with AF (P=0.45).
  • Neither landmark nor time-dependent analysis showed a significantly higher risk of recurrence in patients with ICM-detected AF.

Conclusions:

  • Ischemic stroke recurrence risk was not elevated in patients with cryptogenic stroke and AF detected by ICMs, even with subsequent anticoagulation.
Abstract

Keywords:
atrial fibrillationcryptogenic strokeischemic stroke

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