AI Article Synopsis
- Implantable cardiac monitors (ICMs) can help detect hidden episodes of atrial fibrillation, potentially preventing strokes in patients who've already experienced a stroke or have stroke risk factors.* -
- A systematic review of four trials with 7,237 patients showed that ICMs significantly reduced the risk of ischemic stroke and increased the detection of atrial fibrillation as well as the use of anticoagulants.* -
- While the findings indicate ICMs are beneficial, more research is required due to variability in study populations and the limited number of available studies.*
Article Abstract
Background And Aim: Implantable cardiac monitors (ICM) can facilitate the detection of asymptomatic atrial fibrillation episodes. We performed a systematic review and meta-analysis to investigate whether ICM can prevent stroke in patients with prior stroke and risk factors for stroke.
Methods: This study included randomized controlled trials comparing ICM with conventional (non-ICM) external cardiac monitoring in patients with prior stroke and risk factors for stroke. We searched Medline, Embase, and CENTRAL from inception until January 5, 2022, without language restriction. Quantitative pooling of the data was undertaken using a random-effects model. The primary outcome was ischemic stroke at the longest follow-up.
Results: Four trials comprising 7237 patients were included. ICM was significantly associated with decreased risk of ischemic stroke (RR 0.76; 95% CI, 0.59-0.97; moderate-quality evidence) in patients with prior stroke and risk factors for stroke. ICM was associated with higher detection of atrial fibrillation (RR 4.21, 95% CI 2.26-7.85) and use of oral anticoagulants (RR 2.29, 95% CI 2.07-2.55).
Conclusions: ICM results in a significantly lower risk of ischemic stroke than conventional (non-ICM) external cardiac monitoring in patients with prior stroke and risk factors for stroke. Due to the clinical heterogeneity of study population and limited related studies, more trials were needed to furtherly explore the topic in patients with prior stroke or high risk of stroke.
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Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10358888 | PMC |
| http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0287318 | PLOS |
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