This prospective study aims to identify the diagnostic accuracy of echocardiographic predictors of atrial fibrillation in patients with ESUS (embolic stroke of undetermined source) or TIA (transient ischemic attack).
Cardiac thromboembolism attributed to atrial fibrillation (AF), the most frequent cardiac arrhythmia, is responsible for up to one-third of ischemic strokes. Several factors have been proposed to predict AF, as findings in 12-lead ECG (electrocardiogram) or Holter ECG, epidemiological or echocardiographic parameters. The main purpose of this research project is to test the diagnostic accuracy of the atrial electromechanical conduction time, measured as septal total atrial conduction time "sPA-TDI", an echocardiographic parameter, and the LaHAsPa-Score, which is based on patient characteristics and echocardiographic measurements for the detection of AF in patients diagnosed with ESUS or TIA, utilizing a 7-day ambulatory ECG monitor and incidental detection of AF during a two-year follow-up period, including detection via implantable cardiac monitor or pacemaker, if applicable. Other echocardiographic measurements including left atrial volume index (area-length method), atrial electromechanical delay, left atrial myocardial strain together with laboratory, 12-channel ECG, Holter ECG findings, and established risk scores will be compared to the main parameters of interest. The investigators expect that the results will help with better risk stratification and targeted monitoring periods for atrial fibrillation in patients with ESUS or TIA.
Study Type
OBSERVATIONAL
Enrollment
200
After clinical routine diagnostics an additional ambulatory ECG monitoring for 7 days is established
University Hospital Tulln
Tulln, Austria
RECRUITINGDetection of former unrecognized atrial fibrillation
AF will be defined as an episode of irregular heart rhythm, without detectable P waves, lasting more than 30 seconds
Time frame: 7 days (168 hours of ECG recording)
Detection of atrial fibrillation after 7 days in the follow-up period
participants wearing the device for more than a week or diagnosed with AF after home monitoring period by local physicians or via ICM (implantable cardiac monitor) or pacemaker
Time frame: 24 months
Recurrent ischemic stroke
occurence of ischemic stroke during the follow-up period
Time frame: 24 months
Participants on oral anticoagulation
participants who have been prescribed oral anticoagulants by their treating physician (for any reason)
Time frame: 24 months
Cardiovascular (CV) death
AMI (acute myocardial infarction), sudden cardiac death, death due to heart failure (HF), death due to stroke, death due to CV procedures, death due to CV hemorrhage and other CV causes
Time frame: 24 months
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