The utility of implantable loop recorders in patient management: an age- and indication-stratified study in the outpatient-implant era

Article Cardiac & Cardiovascular Systems

The diagnostic yield of implantable loop recorders stratified by indication: real-world use in a large academic hospital

Alexander Smith et al.

Summary: In a real-world academic hospital setting, the diagnostic rate of ILRs was highest for AF, palpitations, and VA; however, these high yield indications comprised only 29% of all indications. The diagnostic yield for the commonest indication (syncope) was approximately half that reported in the previously published trials. With increasing implantation rates, additional studies are required to refine guideline-based indications for ILR implantation to improve diagnostic yield.

JOURNAL OF INTERVENTIONAL CARDIAC ELECTROPHYSIOLOGY (2021)

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Article Clinical Neurology

Prevalence and predictors of atrial fibrillation in patients with embolic stroke of undetermined source: a real-life single-center retrospective study

Fabio Melis et al.

Summary: The study found that atrial fibrillation could be detected in up to 50% of patients with embolic stroke of undetermined source if a careful diagnostic work-up is employed, particularly with the use of implantable loop recorder. Excessive supraventricular electric activity and left atrial enlargement are significant predictors of atrial fibrillation in these patients.

NEUROLOGICAL SCIENCES (2021)

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Article Emergency Medicine

Experience of a smartphone ambulatory ECG clinic for emergency department patients with palpitation: a single-centre cohort study

Julia Cullen et al.

Summary: The study aimed to evaluate the first year of service at a palpitation and pre-syncope Ambulatory Care Clinic using the AliveCor/Kardia device. Findings showed that 7.2% of patients were diagnosed with cardiac issues, with an average cost of 358 GBP for symptomatic rhythm diagnosis and 4570 GBP for cardiac dysrhythmia diagnosis.

EUROPEAN JOURNAL OF EMERGENCY MEDICINE (2021)

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Article Medicine, General & Internal

Effect of Long-term Continuous Cardiac Monitoring vs Usual Care on Detection of Atrial Fibrillation in Patients With Stroke Attributed to Large- or Small-Vessel Disease The STROKE-AF Randomized Clinical Trial

Richard A. Bernstein et al.

Summary: The STROKE-AF trial demonstrated that among patients with stroke attributed to large- or small-vessel disease, long-term cardiac monitoring with an insertable cardiac monitor (ICM) detected significantly more cases of atrial fibrillation (AF) over 12 months compared to usual care. However, further research is needed to determine the clinical significance of identifying AF in these patients.

JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION (2021)

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Article Medicine, General & Internal

Effect of Implantable vs Prolonged External Electrocardiographic Monitoring on Atrial Fibrillation Detection in Patients With Ischemic Stroke The PER DIEM Randomized Clinical Trial

Brian H. Buck et al.

Summary: This study compared the detection of atrial fibrillation in patients with recent ischemic stroke using implantable loop recorder versus external loop recorder, and found that the implantable loop recorder group had a significantly higher proportion of AF detected over 12 months. Further research is needed to compare clinical outcomes and cost-effectiveness of these monitoring strategies.

JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION (2021)

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Article Cardiac & Cardiovascular Systems