Abstract Details

Title Factors associated with atrial fibrillation detection on longterm cardiac monitoring in Stroke

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P4 - Poster Session 4 (5:30 PM-6:30 PM)

Poster/Presentation
Number 3-049

Objective Our objectives include identification of risk factors, clinical features, and echocadiographic findings associated with atrial fibrillation detection after implantable loop recorder (ILR) procedure in stroke patients.

Background Long-term cardiac monitoring with ILRs increases the detection of atrial fibrillation in cryptogenic stroke. Identification of AF has significant clinical implications, mainly change in the management to prevent strokes. Cardiac structural abnormalities such left atrial size are implicated in atrial fibrillation.

Design/Methods

Data from an ongoing registry of ILR procedures performed at a regional comprehensive stroke center was reviewed. A total of 80 ILRs were implanted by interventional neurology and patients were followed by cardiac electrophysiologist. Univariate and logistic regression analysis was performed to examine relationship of predictors with the dependent variable. Analysis performed using SPSS 24.0.

Results Mean patient age was 65.5 years (sd=11). Prevalence of hypertension and diabetes were 67% and 34% respectively. Current and former smoking was reported in 19.5% and 55%. Vascular imaging (CTA) revealed stenosis (<50%) in extracranial carotid 19% and intracranial stenosis or ICAD 25% in unrelated vascular territory. 100% of the patients had TTE and nearly 40% had TEE. Aortic arch atheroma reported a smild, mod, and severe in 1%, 7% and 4%. Average ejection fraction was 62%. Majority were on ASA compared to Clopidogrel prior to the stroke (34% vs. 5%). Post stroke, 16% were started on dual antiplatelet and 11% on anticoagulation. AF was detected in 11% of the ILR patients within a period of 10 months. Larger left atrial size was associated with detection of atrial fibrillation.

Conclusions Echocardiographic findings such as atrial size is associated with atrial fibrillation detection in stroke patients with long term monitoring using ILR.

Authors/Disclosures
Jane Khalife, MD (Thomas Jefferson University Hospital) PRESENTER	Dr. Khalife has nothing to disclose.
Shyam Majmundar, MD (University of Maryland School of Medicine, Department of Neurosurgery)	Dr. Majmundar has nothing to disclose.
Diana Tzeng, MD (Thomas Jefferson University)	Dr. Tzeng has nothing to disclose.
Robin N. Dharia, MD	Dr. Dharia has nothing to disclose.
Shaista Alam, MD (Jefferson University Hospital)	Dr. Alam has nothing to disclose.
Fred Rincon, MD (Thomas Jefferson University)	Dr. Rincon has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for NeuroCrit, LLC. Dr. Rincon has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for NeuroCrit LLC.
	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
Rodney D. Bell, MD (Thomas Jefferson Medical College)	Dr. Bell has received publishing royalties from a publication relating to health care.
Nabeel Herial, MD, MPH, FAAN (Albany Medical Center)	Dr. Herial has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Medtronic.

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