Detection of occult paroxysmal atrial fibrilation by implantable long-term electrocardiographic monitoring in cryptogenic stroke and transient ischemic attack population: a study protocol for prospective matched cohort study

Abstract

BackgroundCardio-embolic etiology is the most frequently predicted cause of cryptogenic stroke/TIA. Detection of occult paroxysmal atrial fibrillation is crucial for selection of appropriate medication.MethodsEnrolment of eligible cryptogenic stroke and TIA patients began in 2014 and will continue until 2018. The patients undergo long-term (12 months) ECG monitoring (implantable loop recorder) and testing for PITX2 (chromosome 4q25) and ZFHX3 (chromosome 16q22) gene mutations. There will be an appropriate control group of age- and sex-matched healthy volunteers. To analyse the results descriptive statistics, statistical tests for group differences, and correlation analyses will be used.DiscussionIn our study we are focusing on a possible correlation between detection of atrial fibrillation by an implantable ECG recorder, and PITX2 and/or ZFHX3 gene mutations in cryptogenic stroke/TIA patients. A correlation could lead to implementation of this genomic approach to cryptogenic stroke/TIA diagnostics and management. The results will be published in 2018.Trial registrationClinicalTrials.gov: NCT02216370.

Epicardial Fat Thickness and Free Fatty Acid Level are Predictors of Acute Ischemic Stroke with Atrial Fibrillation

“…An ongoing prospective study is testing possible correlations between detection of AF by an implantable ECG recorder and gene mutations in patients with cryptogenic stroke/TIA; results will be available in 2018. 39) Additive biomarkers or clinical variables that have the power to discriminate between ischemic stroke with or without AF would be helpful for outlining future directions, specifically how to best determine whether AF is present and/or whether to start anticoagulant therapy. The results from our study will be useful for identifying undetected AF in patients with ischemic stroke.…”

The complexity of atrial fibrillation newly diagnosed after ischemic stroke and transient ischemic attack: advances and uncertainties

“…Ongoing studies such as Detection of Silent Atrial Fibrillation aFter Ischemic StrOke (SAFFO) [ 104 ], Impact of Standardized Monitoring for Detection of Atrial Fibrillation in Ischemic Stroke (MonDAFIS) [ 105 ], Finding Atrial Fibrillation in stroke patients – Randomized (Find-AF Randomized) [ 106 ], Detection of occult paroxysmal atrial fibrillation by implantable long-term ECG monitoring in cryptogenic stroke and TIA [ 107 ] and PAthophysiology and Risk of Atrial fibrillation Detected after Ischemic StrokE (PARADISE) will probably address many of the currently unknown aspects of AFDAS.…”