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Impacto de la fibrilación auricular detectada por monitor cardíaco insertable en futuros eventos isquémicos después

Ronak Bharucha¹, Jitae Kim¹, Mohammad Alsheikh-Kassim¹

¹Department of Medicine, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, USA.

|January 21, 2026

Resumen

Los monitores cardíacos insertables detectan la fibrilación auricular (FA) después de un accidente cerebrovascular criptogénico (ACV), pero la mayoría de los accidentes cerebrovasculares recurrentes en estos pacientes pueden no estar relacionados con la FA. Se necesitan más ensayos para confirmar el beneficio de la implantación rutinaria de ICM para la prevención secundaria de ACV.

Área de la Ciencia:

Cardiología; Neurología; Dispositivos Médicos

Sus antecedentes:

Los monitores cardíacos insertables (ICM) se utilizan después de un accidente cerebrovascular criptogénico (ACV) para detectar la fibrilación auricular (FA) y guiar el tratamiento.; El impacto de la implantación de ICM en la recurrencia de accidentes cerebrovasculares en pacientes con ACV no está bien establecido.

Objetivo del estudio:

Comparar las tasas de recurrencia de accidentes cerebrovasculares en pacientes con ACV criptogénico con y sin FA detectada por ICM.; Identificar predictores de recurrencia de accidentes cerebrovasculares en esta cohorte.

Principales métodos:

Análisis retrospectivo de 840 pacientes con ACV o ataque isquémico transitorio que recibieron un ICM.; La duración del seguimiento fue de una mediana de 990 días.

Principales resultados:

Se detectó fibrilación auricular (FA) en 235 pacientes (27,9%).; Se produjeron accidentes cerebrovasculares recurrentes en 112 pacientes; el 70,5% de estos ocurrieron en pacientes sin FA detectada.; Los pacientes con FA detectada tuvieron un aumento de la recurrencia de accidentes cerebrovasculares (HR ajustada: 2,73), al igual que aquellos con una puntuación CHA2DS2-VASc ≥4 y sexo masculino.

Conclusiones:

A pesar de que los ICM detectan FA en una parte importante de los pacientes con ACV, la mayoría de los accidentes cerebrovasculares recurrentes pueden deberse a otras causas.; El uso rutinario de ICM para la prevención secundaria de ACV requiere una mayor investigación a través de ensayos aleatorizados.

Palabras clave:

arritmia fibrilación auricular accidente cerebrovascular criptogénico registrador de bucle implantable monitor cardíaco insertable

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