Monday, July 26, 2021

AF After Stroke

REBEL EM - July 26, 2021 - By Thomas del Ninno
Papers: Effect of Long-term Continuous Cardiac Monitoring vs Usual Care on Detection of Atrial Fibrillation in Patients with Stroke Attributed to Large- or Small-Vessel Disease: The STROKE-AF Randomized Clinical Trial
Effect of Implantable vs Prolonged External Electrocardiographic Monitoring on Atrial Fibrillation Detection in Patients with Ischemic Stroke: The PER DIEM Randomized Clinical Trial11
Clinical Question: What is the rate of atrial fibrillation (AF) detection in patients with an implantable cardiac monitoring (ICM) device compared to external cardiac monitoring in patients with a previous ischemic stroke (PER DIEM) or stroke due to large- or small-vessel disease (STROKE-AF)?
Clinical Take Home Point:
An implanated cardiac monitoring device designed to detect atrial fibrillation is able to diagnose atrial fibrillation at a higher rate when compared to standard of care (STROKE-AF) or 30 days of external cardiac monitoring (PER DIEM) at one year. I agree with the authors of both the STROKE-AF and PER DIEM trial, more research is needed to determine the clinical significance of long-term monitoring in the detection of atrial fibrillation using an implanted cardiac monitor when compared to standard of care.