Arrhythmias & electrophysiology
Effect of implantable loop recorder–based continuous rhythm monitoring on incident atrial fibrillation and stroke: An updated systematic review and meta-analysis of randomized controlled trials
Authors' conclusion
Our meta-analysis showed that screening for AF with ILR is associated with increased detection of AF and increased initiation of appropriate anticoagulation therapy in patients with a history of stroke or those with risk factors for stroke. The benefit of stroke risk reduction with ILR remains unclear
Study context
- Population
- Patients with a history of stroke or at high risk for developing stroke
- Participants
- 7,237 patients · 4 RCTs
- Comparison
- Implantable loop recorder (ILR)-based continuous rhythm monitoring vs usual care
- ILRn = 2,114
- non-ILRn = 5,123reference
- Outcome
- Incident atrial fibrillation (AF) detection, appropriate anticoagulation initiation and stroke
Methodological detailsDatabases searched: MEDLINE and EMBASE
- Databases searched: MEDLINE and EMBASE
Pooled result
As reported in the abstract
ILR vs Non-ILRRelative risk (95% CI)P value
Incident AF detection; NNT = 7.7; I2 = 61%
3.88(2.23–6.75)
P < 0.00001Appropriate anticoagulation initiation; NNT = 6.7; I2 = 0
2.29(2.07–2.55)
P < 0.00001Stroke; NNT = 100; I2 = 0%
0.75(0.59–0.95)
P = 0.02Further pooled results
| Outcome | RR (95% CI) | P value | |
|---|---|---|---|
| Incident stroke, patients with history of stroke (subgroup)I2 = 0% | 0.83 (0.61–1.14) | P = 0.25 | |
| 0.512Relative risk (log scale) |
Original publication
Effect of implantable loop recorder–based continuous rhythm monitoring on incident atrial fibrillation and stroke: An updated systematic review and meta-analysis of randomized controlled trials. Heart Rhythm. Published 5 June 2024. doi:10.
Summarised from the published abstract; every number is checked against it