Work

Impact of Insertable Cardiac Monitor-Detected Atrial Fibrillation on Future Ischemic Events Following Cryptogenic Stroke

Year: 2026

Type: article

Abstract: BACKGROUND: Insertable cardiac monitors (ICMs) are often implanted after cryptogenic stroke (CS) to detect atrial fibrillation (AF) and guide anticoagulation. However, the impact of this practice on stroke recurrence remains unclear. OBJECTIVES: This study sought to compare stroke recurrence between CS patients with and without ICM-detected AF and identify predictors of recurrent stroke. METHODS: A retrospective analysis was conducted of consecutive patients admitted to a stroke center with no history of AF who received an ICM for CS or transient ischemic attack. RESULTS: -VASc score <4 and age of <65 years (n = 107), only 1 patient with a recurrent stroke had AF detected (<1%). CONCLUSIONS: Despite the high rate of detection of AF following CS by ICMs, most strokes occurring in this population may not be due to AF. Further randomized trials are needed to verify these observations and clarify the benefit of routine ICM implantation for secondary CS prevention.

Source: JACC Advances

DOI: 10.1016/j.jacadv.2025.102536