Diagnostic yield of external loop recording in patients with acute ischemic stroke or TIA

Abstract

Atrial fibrillation (AF) is a strong risk factor for first-ever stroke and stroke recurrence. The detection rate is low and detection is often costly and time-consuming. We evaluated the diagnostic yield of an external loop recorder (ELR) in patients with acute ischemic stroke or TIA, and assessed factors that are associated with AF detection. We prospectively studied patients admitted to the stroke unit with ischemic stroke or TIA, without a history of AF, and no AF on routine-ECG and 24-h telemetry. Patients received an ELR for another 24-h registration. Rhythm registration with an ELR was performed in 94 patients. AF was identified in 5 patients (5 %). AF was associated with cryptogenic stroke and cortical or subcortical involvement. If ELR was limited to patients with cryptogenic stroke in combination with cortical or subcortical involvement, the detection rate increased to 17 %. Automated recording with ELR was easy to use in the acute setting of ischemic stroke or TIA and seems promising to detect AF or atrial flutter, in particular in patients with cryptogenic stroke in combination with cortical or subcortical symptoms.