The culprit of cryptogenic stroke: the short-term versus long-term atrial fibrillation detection rate in a tertiary care centre

Abstract Funding Acknowledgements Type of funding sources: Public Institution(s). Main source(s): Limburg Clinical Research Center OnBehalf Mobile Health Unit & Future Background Cryptogenic stroke (CS) and transient ischemic attack (TIA) patients have no determined aetiology at discharge. A possible cause for is atrial fibrillation (AF). AF occurs in 20%-40% the CS diagnosis highly dependent on monitoring duration. long-term method insertable loop recorder (ILR), recommended by European Society Cardiology. However, this not routinely used Belgium despite reimbursement. Purpose This study aims to determine detection rates different methods clinical practice, ranging from short-term (monitoring a unit, 12-lead electrocardiogram (ECG), 24-hour ECG), seven-day Holter, (smartphone application ILR). Methods monocentric, retrospective was conducted adults with or TIA between 1/01/17 - 1/01/20. Data were collected electronic medical record. The primary endpoint rate time until first detection. Results total 368 suffered TIA. Most them monitored unit (96%) ECG (93%). 26%, Holter 38%. For monitoring, smartphone 3%. ILRs inserted 6%, median 102 days after (IQR: 48-321). One year ILR insertion, detected 23%. increased duration, as shown figure, except ECG, which AF. Therefore, (5%) (10%; p=.034), short- (16%; p=.01). age without (Mdn = 71yr) lower than those 79yr; p=.001). National Institutes Stroke Scale (NIHSS) CHA2DS2-VASc score 3) 6, p<.001; Mdn 4, p=.004 respectively). one-year mortality 15% compared 8% No an deceased within one stroke. Conclusions Detection associated higher age, NIHSS, scores. These variables can be select insertion ILRs. significantly monitoring. only 38% week, 6% had inserted. guideline recommendations, cardiac underutilised population patients. Nevertheless, still 14% findings emphasise need more app, patient population. Consequently, will result accurate treatment secondary prevention CS. Figure. Time