ArticleHeart rhythm O22022
Longitudinal outcomes in cryptogenic stroke patients with and without long-term cardiac monitoring for atrial fibrillation.
Article in Heart rhythm O2, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
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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.
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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.
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Who cites it
12 citing papers in PubMed, 1 synthesis or guideline pooled it, 15 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
- Heart Rhythm Monitoring Practices, Detection of Atrial Fibrillation, and Effect of Anticoagulation in the ARCADIA Trial.Journal of the American Heart Association · 2025Trial
- A Large, Real-World Cohort Analysis of Arrhythmia Detection and Therapeutic Interventions in Patients With Insertable Cardiac Monitors and Long-Term Monitoring.Journal of cardiovascular electrophysiology · 2026Article
- Incidence and predictors of recurrent stroke in patients with cryptogenic stroke later diagnosed with atrial fibrillation: a 5-year cohort study from a tertiary care hospital.Annals of medicine and surgery (2012) · 2026Article
- Continuing evaluation of atrial fibrillation detection after cryptogenic stroke: 2-year findings from a multicentre study with Confirm Rx ICM.Open heart · 2025Article
- Long-Term Detection of Subclinical Atrial Fibrillation in Cryptogenic Stroke Patients With Insertable Cardiac Monitors.European journal of neurology · 2025Article
- Reimagining Cryptogenic Stroke Care: Collaborative Care and Inpatient Insertable Cardiac Monitors for Detection of Atrial Fibrillation.Stroke (Hoboken, N.J.) · 2024Article
- Effectiveness, utilisation and cost associated with implantable loop recorders versus external monitors after ischaemic or cryptogenic stroke.Open heart · 2024Article
- Diagnosis and Management of Atrial Fibrillation in Acute Ischemic Stroke in the Setting of Reperfusion Therapy: Insights and Strategies for Optimized Care.Journal of cardiovascular development and disease · 2023Review
- Insertable cardiac monitoring results in higher rates of atrial fibrillation diagnosis and oral anticoagulation prescription after ischaemic stroke.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
- Searching for atrial fibrillation post stroke: is it time for digital devices?Frontiers in cardiovascular medicine · 2023Review
- Implantable cardiac monitors in cryptogenic stoke: Clarity or added uncertainty?Heart rhythm O2 · 2022Article
Corrections and comments
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Authors and funding
8 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Guidelines recommend a confirmed diagnosis of atrial fibrillation (AF) to initiate oral anticoagulation in cryptogenic stroke (CS) patients. However, the intermittent nature of AF can make detection challenging with intermittent short-term cardiac monitoring. Objective: The purpose of this retrospective cohort study was to examine post-CS utilization of cardiac monitoring and associated clinical outcomes. Methods: Adults with incident hospitalization for CS were identified in the Optum® claims database and assessed for cardiac monitoring received poststroke. Patient were stratified into those with a long-term insertable cardiac monitor (ICM) vs external cardiac monitor (ECM) only. The timing of ICM placement poststroke was treated as a time-dependent covariate. The clinical outcomes of interest were time to AF diagnosis, oral anticoagulation usage, and all-cause mortality. Results: A total of 12,994 patients met selection criteria for the analysis, of whom 1949 (15%) received an ICM and 11,045 (85%) received ECM only. In those who had received an ECM as their first monitoring modality, only 4.4% moved on to receive an ICM for longer-term monitoring. Use of ECM before ICM was associated with a longer time to AF diagnosis (median 336 vs 194 days). Compared to those with ECM only, ICM patients had a significantly lower rate of death (hazard ratio [HR] 0.70; Conclusion: In a real-world study of CS patients, prolonged cardiac monitoring was associated with higher rates of AF detection and treatment, and higher odds of survival.
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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.