A study published in JAMA Neurology, led by Northwestern Medicine, reveals that insertable cardiac monitors may detect atrial fibrillation more effectively in stroke patients than standard monitoring methods.
Atrial fibrillation, characterized by an irregular and rapid heartbeat, significantly increases the risk of ischemic stroke, especially in patients with other stroke risk factors.
It can make the heart’s upper chambers beat chaotically, impacting blood flow. As per the Centers for Disease Control and Prevention, this condition can increase the risk of stroke by five times.
The STROKE AF Clinical Trial
The STROKE AF clinical trial, initially showing results over one year, found a higher incidence of atrial fibrillation in patients who had experienced an ischemic stroke related to cardiovascular disease.
The trial compared the effectiveness of insertable cardiac monitors versus standard medical monitoring.
In the extended study, over 300 patients aged 60 or older, or those 50 to 59 with additional stroke risk factors, were monitored for three years.
These patients had previously suffered from ischemic stroke attributed to large-artery atherosclerotic disease (LAD) or small-vessel occlusive disease (SVD). The findings were startling:
- 22.7% of patients with insertable cardiac monitors developed atrial fibrillation.
- Only 2.4% in the standard monitoring group showed similar results.
This significant difference highlights the potential of cardiac monitors in detecting atrial fibrillation more effectively than traditional methods.
Implications for Stroke Patients
Lead author Richard Bernstein, MD, Ph.D., emphasizes that the cause of the first stroke doesn’t always indicate the best prevention strategy for future strokes.
Therefore, addressing all risk factors is crucial. Insertable cardiac monitors offer a more reliable way to detect atrial fibrillation, a common hidden cause of recurrent strokes.
While the results are promising, Bernstein advises careful consideration before widespread implementation of cardiac monitors in stroke patients.
He suggests that monitoring should be considered for the majority of stroke patients, especially if treating atrial fibrillation would be a priority upon detection.
Conclusion
The study underscores the importance of enhanced monitoring for atrial fibrillation in patients with a history of ischemic stroke.
Insertable cardiac monitors could play a key role in preventing secondary strokes by detecting atrial fibrillation that standard methods might miss.
However, further research is needed to confirm these benefits and to establish guidelines for the widespread use of these devices in stroke prevention strategies.
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The research findings can be found in JAMA Neurology.
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