Arrhythmias & electrophysiologyCohort study
Impact of Insertable Cardiac Monitor-Detected Atrial Fibrillation on Future Ischemic Events Following Cryptogenic Stroke
- retrospective analysis
- consecutive patients
- single stroke center
Authors' conclusion
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.
Study context
- Population
- Patients admitted to a stroke center with no history of atrial fibrillation (AF) who received an ICM for cryptogenic stroke (CS) or transient ischemic attackmedian follow-up 990 days, AF detected in 235
- Participants
- 840 patients
- Exposure
- stroke recurrence between CS patients with and without ICM-detected AF
- AFn = 235
Main finding
Recurrent stroke · median follow-up 990 days
Adjusted hazard ratio
2.73
95% CI 1.33–5.59
AF vs No AF
adjusted HR 2.73 (95% CI 1.33–5.59)
As reported in the abstract
- Patients with recurrent strokes
- 112
- Recurrent strokes in patients without AF ever being detected
- 70.5%
- Patients with AF started on anticoagulation
- 97.9%
Observational data: associations, not effects.
Further findings
Other predictors of recurrent stroke (multivariable)
- CHA2DS2-VASc score ≥4 associated with increased risk
- Male sex associated with increased risk
Recurrent stroke with AF detected, CHA2DS2-VASc score <4 and age of <65 years (exploratory subgroup)
- Subgroup n
- 107
- Patients with a recurrent stroke who had AF detected
- 1 patient (<1%)
- exploratory subgroup analysis
Original publication
Impact of Insertable Cardiac Monitor-Detected Atrial Fibrillation on Future Ischemic Events Following Cryptogenic Stroke. JACC Adv. Published 20 January 2026. doi:10.1016/j.jacadv.2025.102536
Summarised from the published abstract; every number is checked against it