Background And Purpose: Patients with cryptogenic ischemic stroke may have undetected paroxysmal atrial fibrillation (PAF). We established the Stroke and Monitoring for PAF in Real Time (SMART) Registry to determine the yield of 30-day outpatient PAF monitoring in cryptogenic ischemic stroke.
Methods: The SMART Registry was a 3-year, prospective multicenter registry of 239 patients with cryptogenic ischemic stroke undergoing 30-day outpatient autotriggered PAF detection in Kaiser Permanente Northern California.
Results: In intention-to-monitor analysis, PAF was detected in 29 of 239 patients (12.1%; 95% CI, 8.6%-16.9%). After retrospective chart review was performed, a new diagnosis of PAF was confirmed in 26 of 236 patients (11.0%; 95% CI, 7.6%-15.7%). The majority of detected PAF events were asymptomatic; only 6 of 98 recorded PAF events (6.1%) were patient-triggered or associated with symptoms.
Conclusions: -Approximately 1 in every 9 patients with cryptogenic ischemic stroke was found to have new PAF within 30 days. Routine monitoring in this population should be strongly considered.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1161/STROKEAHA.112.665844 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
The potential role of cardiac CT in ischemic stroke: bridging cardiovascular and cerebrovascular health.
Acta Neurol Belg
December 2024
Department of Neurology, School of Medicine, The 2nd Affiliated Hospital of Zhejiang University, #88 Jiefang Road, Hangzhou, China.
Ischemic stroke, accounting for approximately 80% of all stroke cases, remains a leading cause of death and disability worldwide. Effective management of ischemic stroke is heavily influenced by its etiology, which can range from large-artery atherosclerosis and cardiac embolism to cerebral small-vessel occlusions and cryptogenic strokes. Cardioembolic stroke, which makes up about 30% of ischemic strokes, often leads to more severe symptoms and worse outcomes, necessitating anticoagulation therapy for prevention.
View Article and Find Full Text PDFOptimal Antithrombotic Regimen After Cryptogenic Stroke: A Systematic Review and Network Meta-Analysis.
Clin Appl Thromb Hemost
December 2024
Department of Psychiatry, New York City Health and Hospitals/Bellevue, New York, NY, USA.
Although several antithrombotic strategies have been investigated for the management of cryptogenic strokes, ie, ischemic strokes without known etiologies, an optimal antithrombotic strategy for cryptogenic strokes is unknown. We aim to assess oral antithrombotic agents' comparative efficacy and safety after cryptogenic stroke to identify an optimal treatment.A systematic review and meta-analysis synthesizing evidence from randomized controlled trials (RCTs) obtained from PubMed, Embase Cochrane, Scopus, and Web of Science until February 2024.
View Article and Find Full Text PDFBony Stroke on Rheumatoid Arthritis: A Rare Entity or a Missed Diagnosis?
Cureus
November 2024
Neuroradiology Department, Unidade Local de Saúde de São João, Porto, PRT.
Bone or cartilage anomalies affecting the arteries supplying the brain can be a structural cause of ischemic stroke. Due to their rarity, there is currently no standardized approach for evaluating and treating these so-called bony strokes. We present a case of a 79-year-old woman with a history of cranial settling due to rheumatoid arthritis (RA) and moderate disability, who presented with insidious dizziness and gait disturbances over three weeks.
View Article and Find Full Text PDFDiagnosis of Atrial Fibrillation as the Source of Cryptogenic Retrieved Clots by a Novel Thrombin Secretion Assay.
Heart Rhythm
December 2024
Department of Neurology, The Chaim Sheba Medical Center, Ramat Gan 5266202, Israel; Department of Neurology and Neurosurgery, Faculty of Medicine and Health Sciences, Tel Aviv University, Tel Aviv 6997801, Israel; The TELEM Rubin Excellence in Biomedical Research Program, The Chaim Sheba Medical Center, Ramat Gan, Israel. Electronic address:
Background: Secondary prevention of acute ischemic stroke depends on identifying the source of cryptogenic clots. We previously reported that secreted thrombin activity from endovascularly retrieved clots is significantly different in atrial fibrillation (AF) versus atherosclerosis (AS) related, probably due to the in-vivo biology of the clots.
Objectives: To validate and optimize thrombin secretion for clot source diagnosis.
Academic and Community Hospitals differ in stroke subtype classification and cardiac monitoring: the DiVERT multi-center cohort study.
Front Neurol
December 2024
CHI Memorial Neuroscience Institute, Common Spirit Health System, Chattanooga, TN, United States.
Background: Cardiac monitoring strategies to detect occult atrial fibrillation (AF) post-stroke differ among healthcare institutions. This may be related to discrepancies in stroke subtype classification/adjudication, and/or consultation of cardiology specialists at Community Hospitals (CoH) and Academic Centers (AcC). Identifying the degree of heterogeneity may encourage development of guideline-directed monitoring protocols, result in higher AF detection rates and treatments, and fewer strokes.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!