SynthesisThe American journal of cardiology2022
Meta-Analysis of Randomized Clinical Trials Comparing the Impact of Implantable Loop Recorder Versus Usual Care After Ischemic Stroke for Detection of Atrial Fibrillation and Stroke Risk.
Synthesis in The American journal of cardiology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
20 citing papers in PubMed, 2 syntheses or guidelines pooled it, 27 citations in OpenAlex.
- Value of implantable loop recorders in detecting atrial fibrillation for stroke prevention: a systematic review and meta-analysis.Open heart · 2025Pooled it
- Association between implantable loop recorder use and secondary stroke prevention: a meta-analysis.Open heart · 2022Pooled it
- Echocardiographic Parameters for Predicting Atrial Fibrillation Following Ischemic Stroke: The PER DIEM Echocardiography Substudy.Echocardiography (Mount Kisco, N.Y.) · 2026Trial
- The throne of health care: detection of cardiac arrhythmias on a toilet-seat.Clinical research in cardiology : official journal of the German Cardiac Society · 2026Article
- Impaired left atrial strain is associated with acute ischemic stroke in patients without atrial fibrillation.Frontiers in stroke · 2026Article
- Digital Health-Enabled Monitoring Strategies for Atrial Fibrillation Detection after Embolic Stroke of Undetermined Source: A Cost-Effectiveness Analysis of Implantable Loop Recorders, Wearable Devices, and Usual Care.Cerebrovascular diseases (Basel, Switzerland) · 2025Article
- Treatment of patent foramen ovale.EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology · 2025Review
- Atrial Imaging and Cardiac Rhythm in Cryptogenic Embolic Stroke: The ARIES Study.Journal of the American Heart Association · 2024Observational
- Effectiveness, utilisation and cost associated with implantable loop recorders versus external monitors after ischaemic or cryptogenic stroke.Open heart · 2024Article
- Diagnostic Yield and Clinical Implications of Implantable Loop Recorders in Patients with Syncope in Germany: A National Database Analysis.Journal of clinical medicine · 2024Article
- Predictors of atrial fibrillation detection in embolic stroke of undetermined source patients with implantable loop recorder.Frontiers in cardiovascular medicine · 2024Article
- Improved diagnostic performance of insertable cardiac monitors by an artificial intelligence-based algorithm.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2023Article
- Incidence of clinical atrial fibrillation and related complications using a screening algorithm at a nationwide level.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2023Article
- Practice Patterns and Outcomes Associated With Anticoagulation Use Following Sepsis Hospitalizations With New-Onset Atrial Fibrillation.Circulation. Cardiovascular quality and outcomes · 2023Observational
- Technology engagement is associated with higher perceived physical well-being in stroke patients prescribed smartwatches for atrial fibrillation detection.Frontiers in digital health · 2023Article
- External Validation of SAFE Score to Predict Atrial Fibrillation Diagnosis after Ischemic Stroke: A Retrospective Multicenter Study.Stroke research and treatment · 2023Article
- Searching for atrial fibrillation post stroke: is it time for digital devices?Frontiers in cardiovascular medicine · 2023Review
- False Atrial Fibrillation Alerts from Smartwatches are Associated with Decreased Perceived Physical Well-being and Confidence in Chronic Symptoms Management.Cardiology and cardiovascular medicine · 2023Article
- Programming Optimization in Implantable Cardiac Monitors to Reduce False-Positive Arrhythmia Alerts: A Call for Research.Diagnostics (Basel, Switzerland) · 2022Article
- Unveiling the silent enemy: Revisiting post-stroke AF detection.Indian pacing and electrophysiology journalArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors at 5 institutions in 2 countries.
Funding
Abstract
Implantable loop recorder (ILR) is recommended to detect subclinical atrial fibrillation (AF) after cryptogenic stroke; however, the clinical outcomes of this practice is unclear. We conducted a systematic review and meta-analysis of randomized controlled trials to evaluate 12-month AF detection, change in oral anticoagulation (OAC), and recurrent stroke in ILR versus usual care after ischemic stroke. We searched Medline, Embase, Web of Science, Cochrane Library for randomized controlled trials comparing ILR with usual care after any ischemic stroke. Primary outcomes were cumulative AF detection and recurrent stroke (ischemic or hemorrhagic) or transient ischemic attack over 12 months. Secondary outcome was OAC initiation. Meta-analysis was performed with Mantel-Haenszel pooled odds ratios (ORs) and random effects models. Of 200 identified articles, 3 trials were included (1,233 participants). Cryptogenic stroke and underlying AF included cryptogenic stroke only, stroke of known cause and underlying-AF included small or large vessel stroke only, and post embolic rhythm detection with implantable vs external monitoring included all ischemic strokes. The 12-month AF detection was 13% in the ILR group and 2.4% in controls. ILR was more likely to detect AF compared with usual care (OR 5.8, 95% confidence interval 3.2 to 10.2). Stroke or transient ischemic attack occurred in 7% with ILR and 9% with usual care (OR 0.8, 95% confidence interval 0.5 to 1.2). In patients with detected AF, 97% and 100% were started on OAC in cryptogenic stroke and underlying AF and post embolic rhythm detection with implantable vs external monitoring, respectively, compared with 68% in stroke of known cause and underlying-AF. In conclusion, ILR was superior to usual care in AF detection, but the relative low incidence of AF and the nondifferential risk of stroke between the ILR and usual care arms may suggest that most patients do not benefit from ILR implantation. Further studies are warranted to understand if patient selection can be improved to increase the diagnostic yield of ILR.
Indexed as
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.