ArticleNeurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology2024
Predictors of atrial fibrillation after embolic stroke of undetermined source in patients with implantable loop recorders.
Article in Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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4 citing papers in PubMed, 2 citations in OpenAlex.
- Implantable Cardiac Monitoring for Atrial Fibrillation Detection in Patients with Stroke: A Systematic Review and Meta-Analysis.NeuroSci · 2026Review
- New-Onset POAF After Craniotomy: Impact on Neurological Outcome, ICU Utilization, and Mortality.Journal of clinical medicine · 2026Article
- Cardioembolic stroke versus embolic stroke of undetermined source: early severity and long-term outcomes in a prospective cohort.BMC neurology · 2025Article
- Newly Diagnosed Atrial Fibrillation Indicators in Cryptogenic Stroke Survivors' P-Wave Indices: A Systematic Review and Meta-Analysis.Journal of arrhythmia · 2025Article
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8 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIn patients with embolic stroke of undetermined source (ESUS), underlying subclinical atrial fibrillation (AF) is often suspected. Previous studies identifying predictors of AF have been limited in their ability to diagnose episodes of AF. Implantable loop recorders enable prolonged, continuous, and therefore more reliable detection of AF. The aim of this study was to identify clinical and ECG parameters as predictors of AF in ESUS patients with implantable loop recorders.
methods101 ESUS patients who received an implantable loop recorder between 2012 and 2020 were included in this study. Patients were followed up regularly on a three-monthly outpatient interval.
resultsDuring a mean follow-up of 647 ± 385 days, AF was detected in 26 patients (26%). Independent risk factors of AF were age ≥ 60 years (HR 2.753, CI 1.129-6.713, p = 0.026), P-wave amplitude in lead II ≤ 0.075 mV (HR 3.751, CI 1.606-8.761, p = 0.002), and P-wave duration ≥ 125 ms (HR 4.299, CI 1.844-10.021, p < 0.001). In patients without risk factors, the risk of developing AF was 16%. In the presence of one risk factor, the probability increased only slightly to 18%. With two or three risk factors, the risk of AF increased to 70%.
conclusionAF was detected in about one in four patients after ESUS in this study. A comprehensive evaluation involving multiple parameters and the existence of multiple risk factors yields the highest predictive accuracy for detecting AF in patients with ESUS.
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