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About two-thirds of patients with ischemic stroke suffer from valve abnormality atrial fibrillation (AF) or atrial flutter, which is an important cardiac risk factor associated with stroke
.
Clinically, for patients with recent ischemic stroke but no evidence of AF ECG, the guidelines recommend 2-4 weeks of ECG monitoring to eliminate the risk of AF
Diagnosing arrhythmia Recently, researchers have investigated the effect of long-term ECG monitoring devices on the detection rate of AF after ischemic stroke
This study was carried out in Canada to investigate whether the 12-month implantable circulatory recording monitoring detected more atrial fibrillation in recent ischemic stroke patients compared with the traditional external circulation recording monitoring for 30 days.
300 patients Patients with ischemic stroke and no history of atrial fibrillation within the last 6 months participated in the study, and were randomized to receive an implantable loop recorder for long-term ECG monitoring (n=150 for 12 months) or an external loop recorder (n= 150 for 30 days)
.
The main result of the study is the occurrence of definite or very likely AF, and the secondary results include new AF within 12 months, recurrent ischemic stroke, cerebral hemorrhage, death, and equipment-related serious adverse events
The average age of the patients was 64.
1 years, and there were 121 females.
273 (91.
0%) completed 24 hours or longer cardiac monitoring, and 259 (86.
3%) completed designated monitoring and 12-month follow-up
.
15.
15.
12-month AF detection rate difference between groups
The study believes that for patients with a recent ischemic stroke but no evidence of atrial fibrillation in the past, the 12-month implantable ECG monitoring has significantly improved the detection rate of atrial fibrillation compared with the conventional 30-day external circulation monitoring, and further research is needed in the future Let’s examine the clinical results and cost-effectiveness of long-term implantable ECG monitoring
.
Further research is needed to investigate the long-term Clinical results and cost-effectiveness of implantable ECG monitoring
.
For patients with a recent ischemic stroke but no evidence of atrial fibrillation in the past, 12 months of implantable ECG monitoring has a significant increase in the detection rate of atrial fibrillation compared with the conventional 30-day external circulation monitoring.
Original source:
Brian H.
Effect of Implantable vs Prolonged External Electrocardiographic Monitoring on Atrial Fibrillation Detection in Patients With Ischemic Stroke The PER DIEM Randomized Clinical Trial.
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