Implantable ECG Device Effectively Improves Atrial Fibrillation Detection in Ischemic Stroke Patients, Study Shows

Implantable ECG Device Effectively Improves Atrial Fibrillation Detection in Ischemic Stroke Patients, Study Shows

According to the results of the PER DIEM trial, 12-month implantable ECG monitoring was more likely to detect AF than 30-day external monitoring in ischemic stroke patients without prior evidence of AF.

We randomly assigned 300 ischemic stroke patients with undiagnosed AF (median age 64 years; 40% women; median CHA2DS2-VASc score 4) to receive a long-term implantable loop recorder (Reveal LINQ, Medtronic), plus remote monitoring (MyCareLink, Medtronic) or external event-triggered loop recorders (Spiderflash-t, Sorin).

Brian H. Buck, MD, MS, associate professor of neurology at the University of Alberta in Edmonton, Canada, and colleagues wrote in JAMA: At 12 months, 15.3% of the implanted group and 4.7% of the implanted group % of the outer group had definite or probable AF (defined as a definite episode of AF lasting at least 2 minutes), and the primary outcome was a between-group difference of 10.7 percentage points; 95% confidence interval, 4 - 17.3; RR = 3.29; 95% confidence interval, 1.45 - 7.42; P = 0.003.

The secondary outcome of time to first atrial fibrillation lasting at least 2 minutes was lower in the implanted group compared with the external group (adjusted HR = 3.36; 95% CI, 1.44-7.84; P = 0.005; log-rank P = 0.002), according to the researchers, the secondary outcome of death or AF testing at 12 months occurred more frequently in the implanted group (17.3% vs 6.7%; between-group difference 10.7 percentage points; 95% CI, 3.4-17.9 ; P = 0.007; aHR = 2.64; 95% CI, 1.27-5.29; P = 0.009).

There were no differences between the groups in secondary outcomes such as transient ischemic attack, recurrent ischemic stroke, intracerebral hemorrhage, or death. One serious device-related adverse event occurred in the implanted group and none in the externalized group. All diagnoses of atrial fibrillation resulted in prescriptions for oral anticoagulants, the researchers wrote.

Buck and his colleagues wrote: "There will be cost implications for long-term cardiac monitoring of all stroke patients and no documented development of atrial fibrillation. The implantable loop recorder used in this study is a single-use Devices. Although the daily PER DIEM trial found that the amount of monitoring required for AF was relatively low, it remains unproven whether wider adoption of implantable loop recorders would translate into lower stroke rates and health benefits ...studies are needed to identify subgroups of stroke patients in which empiric anticoagulation is more cost-effective than expanded cardiac monitoring strategies."

Pray-med Medical is a professional manufacturer of monitor consumables. It has been producing and selling for 10+ years. The ECG lead wires have been certified by many countries and have a complete range. ECG products include monitor ECG lead wires, ECG cables, disposable, repeatable, split, integrated, and all adapters. Please contact us if necessary.