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Cardiac Monitor Implant Detects A-Fib in More Stroke Patients

WEDNESDAY, June 9, 2021 -- Among patients with ischemic stroke attributed to large- or small-vessel disease, an insertable cardiac monitor (ICM) more frequently detects atrial fibrillation (AF) over 12 months than usual care with external cardiac monitoring, according to a study published in the June 1 issue of the Journal of the American Medical Association.

Richard A. Bernstein, M.D., Ph.D., from the Feinberg School of Medicine of Northwestern University in Chicago, and colleagues assessed whether long-term cardiac monitoring is more effective than usual care for AF detection in patients with stroke attributed to large- or small-vessel disease. Patients were randomly assigned to receive either ICM insertion within 10 days of the index stroke (242 patients) or site-specific usual care consisting of external cardiac monitoring (250 patients).

The researchers found that AF detection at 12 months was significantly higher in the ICM group versus the control group (27 patients [12.1 percent] versus four patients [1.8 percent]; hazard ratio, 7.4). Insertion procedure-related adverse events were reported in four of the 221 patients in the ICM group who received an ICM (site infection in one, incision site hemorrhages in two, and implant site pain in one patient).

"We found that a significant minority of patients with stroke not thought to be related to AF actually have AF, but we can only find it with an implantable monitor," Bernstein said in a statement.

Several authors disclosed financial ties to medical device companies, including Medtronic, which supported the study.

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