Abstract
Background: It is important to evaluate patients with transient ischemic attack (TIA) or stroke for atrial fibrillation (AF) because the detection of AF changes the recommended anti-thrombotic regimen from treatment with an antiplatelet agent to oral anticoagulation. This study describes the diagnostic yield of a patch-based, single-use, and water-resistant 14-day continuous cardiac rhythm monitor (ZIO Patch) in patients with stroke or TIA.Methods: We obtained data from the manufacturer and servicer of the ZIO Patch (iRhythm Technologies). Patients who were monitored between January 2012 and June 2013 and whose indication for monitoring was TIA or stroke were included. The duration of monitoring, the number and type of arrhythmias, and the time to first arrhythmia were documented.Results: One thousand one hundred seventy-one monitoring reports were analyzed. The mean monitor wear time was 10.9 days and the median wear time was 13.0 days (interquartile range 7.2–14.0). The median analyzable time relative to the total wear time was 98.7% (IQR 96.0–99.5%). AF was present in 5.0% of all reports. The mean duration before the first episode of paroxysmal AF (PAF) was 1.5 days and the median duration was 0.4 days. 14.3% of first PAF episodes occurred after 48 h. The mean PAF burden was 12.7% of the total monitoring duration.Conclusion: Excellent quality of the recordings and very good patient compliance coupled with a substantial proportion of AF detection beyond the first 48 h of monitoring suggest that the cardiac patch is superior to conventional 48-h Holter monitors for AF detection in patients with stroke or TIA.
Highlights
It is important to evaluate patients with stroke or transient ischemic attack (TIA) for atrial fibrillation (AF), because the detection of AF changes the recommended anti-thrombotic regimen from treatment with an antiplatelet agent to treatment with oral anticoagulation [1].Atrial fibrillation is a well-recognized cause of stroke and TIA and recent studies of extended cardiac rhythm monitoring demonstrate that AF may be responsible for a greater proportion of unexplained strokes than previously realized
In the recent CRYSTALAF study, AF was detected in 29% of cryptogenic stroke patients who underwent 1 year of cardiac monitoring with an implantable cardiac loop recorder [3]
These results suggest an important role for extended cardiac monitoring in the evaluation of patients with stroke or TIA
Summary
It is important to evaluate patients with stroke or transient ischemic attack (TIA) for atrial fibrillation (AF), because the detection of AF changes the recommended anti-thrombotic regimen from treatment with an antiplatelet agent to treatment with oral anticoagulation [1].Atrial fibrillation is a well-recognized cause of stroke and TIA and recent studies of extended cardiac rhythm monitoring demonstrate that AF may be responsible for a greater proportion of unexplained strokes than previously realized. It is important to evaluate patients with stroke or transient ischemic attack (TIA) for atrial fibrillation (AF), because the detection of AF changes the recommended anti-thrombotic regimen from treatment with an antiplatelet agent to treatment with oral anticoagulation [1]. The detection of supraventricular tachycardia (SVT) may be important as well as it is associated with the development of AF and an increased risk of stroke even in patients without AF [4,5,6] These results suggest an important role for extended cardiac monitoring in the evaluation of patients with stroke or TIA. It is important to evaluate patients with transient ischemic attack (TIA) or stroke for atrial fibrillation (AF) because the detection of AF changes the recommended anti-thrombotic regimen from treatment with an antiplatelet agent to oral anticoagulation. This study describes the diagnostic yield of a patch-based, single-use, and water-resistant 14-day continuous cardiac rhythm monitor (ZIO Patch) in patients with stroke or TIA
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
