The purpose of this study is to determine the incidence of paroxysmal atrial fibrillation (AF) in ischemic stroke patients who have a presumed known stroke etiology other than atrial fibrillation.
Recent studies suggest that their is a relatively high incidence of silent paroxysmal atrial fibrillation (PAF) in cryptogenic ischemic stroke patients. Detection of silent PAF in this population, however, requires prolonged cardiac monitoring. On the other hand, there is no understanding of the frequency of silent PAF in patients with a "known" or presumed etiology for their ischemic stroke other than AF. If this incidence is also found to be significant, a dramatic change in stroke evaluation and management would likely occur. This study intends to find the incidence of PAF in a population of recent (within 7 days) ischemic stroke patients (or MRI positive "transient ischemic attack (TIA)" patients) who have presumed etiology for their stroke other than atrial fibrillation or other high risk cardiac lesion. Stroke etiology will be determined through a standard post-stroke evaluation that includes: * Brain MRI * 12-lead electrocardiogram (ECG) for AF detection * 24-h ECG monitoring for AF detection (eg, Holter monitor or cardiac telemetry) * Transthoracic and/or Transesophageal echocardiogram * CT or MR angiography of the head and neck * Hypercoagulable blood panel for patients less than 55 years-old. Preliminary hypercoagulable work-up within 7 days will include the antiphospholipid antibody syndrome results, which will be needed to determine stroke management. All other results, which could take longer to return, including genetic tests of hypercoagulability, rarely change stroke management. To find occult PAF in this population, participants will have an insertable cardiac monitor (Reveal LINQ ICM) implanted within 7 days of the incident stroke and will be monitored for at least 1 year.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
DIAGNOSTIC
Masking
NONE
Enrollment
53
North Shore University Hospital
Manhasset, New York, United States
Long Island Jewish Medical Center
New Hyde Park, New York, United States
Incidence of Paroxysmal Atrial Fibrillation (AF) in Ischemic Stroke Patients
The incidence of paroxysmal atrial fibrillation (AF) in ischemic stroke patients who have a presumed known stroke etiology other than atrial fibrillation.
Time frame: 1 year
Patients Who Are Diagnosed With AF Who Are Changed to Anticoagulant Therapy.
Percentage of patients who are diagnosed with AF who are changed to anticoagulant therapy.
Time frame: 1 year
Duration of AF Episodes.
Duration of AF episodes (mean and range).
Time frame: 1 year
Percentage of Asymptomatic AF
Percentage of asymptomatic AF episodes.
Time frame: 1 year
Incidence of Recurrent Stroke
Incidence of recurrent ischemic stroke.
Time frame: 1 year
Number of Patients That Had Multiple AF Episodes
Number of patients that had multiple AF episodes.
Time frame: 1 year
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