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Utility Of Implantable Loop Recorders for Arrhythmia Detection Beyond Atrial Fibrillation in Cryptogenic Stroke Patients
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  • Taqi Rizvi,
  • Shahkar Khan,
  • Nnedi Asogwa,
  • Ahmad Mustafa,
  • Hai Xu,
  • Gennifer Wahbah Makhoul,
  • Samer Asmar,
  • Chapman Wei,
  • Philippe Akhrass,
  • Rina Shah,
  • Marcin Kowalski,
  • Valay Parikh
Taqi Rizvi
Staten Island University Hospital

Corresponding Author:taqiar3@gmail.com

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Shahkar Khan
Staten Island University Hospital
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Nnedi Asogwa
Staten Island University Hospital
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Ahmad Mustafa
Staten Island University Hospital
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Hai Xu
Staten Island University Hospital
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Gennifer Wahbah Makhoul
Staten Island University Hospital
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Samer Asmar
Staten Island University Hospital
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Chapman Wei
Staten Island University Hospital
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Philippe Akhrass
Staten Island University Hospital
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Rina Shah
Staten Island University Hospital
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Marcin Kowalski
Staten Island University Hospital
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Valay Parikh
Staten Island University Hospital
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Abstract

Introduction Implantable loop recorders (ILR) are recommended to detect atrial fibrillation (AF) in cases of cryptogenic stroke (CS). However, the utility of loop recorder for detection of other actionable arrhythmias in these patients is limited. Objective: To evaluate the utility of ILR to detect arrythmias other than AF in patients with cryptogenic stroke. Methods: We enrolled consecutive CS patients referred for an ILR. A retrospective chart review was conducted from 2018 to 2021. All patients were monitored for a minimum of one year. Results: The cohort included 260 consecutive patients with cryptogenic stroke with a mean age of 68. 2 +/- 13.27 years patients of this cohort had at least one actionable arrhythmic event. AF was found in 47 (18%) patients and 44 (17%) patients were found to have other arrhythmias. Out of these 44 patients, 23 patients (9%) were found to have supraventricular tachycardias (SVT), 4 patients (2%) had ventricular tachycardias, 9 patients (3%) had pauses, 8 patients (3%) had significant bradycardia events. Anticoagulation was initiated in all 47 patients with AF. A total of 15 patients (6%) underwent procedures which included 7 pacemakers, 1 implantable cardioverter-defibrillator, 1 SVT ablation, 6 electrophysiology studies because of ILR findings. Conclusion: ILRs can successfully identify AF in patients with cryptogenic stroke. However, there is a high incidence of other arrythmias that can be detected by implanting ILRs that would otherwise would not be identified or have delayed detection. The study demonstrates the advantage of long-term remote monitoring of patients with CS beyond AF detection.
29 May 2024Submission Checks Completed
29 May 2024Assigned to Editor
29 May 2024Review(s) Completed, Editorial Evaluation Pending
30 May 2024Reviewer(s) Assigned