Objective:

To evaluate the diagnostic yield of detecting atrial fibrillation (AF) and/or atrial flutter (AFL) with extended cardiac patch monitoring in our cryptogenic stroke population.

Background:

Cryptogenic stroke accounts for 15-40% of yearly strokes with increased incidence in younger patients. It is standard of care at our comprehensive stroke center located in the stroke belt to discharge cryptogenic stroke patients with a 14-day continuous cardiac monitoring patch (Zio) to evaluate for paroxysmal AF/AFL. 

Design/Methods:

We propose to conduct a retrospective chart review from January 2019 to June 2022 (3.5 years) of all adult stroke patients with a discharge diagnosis of ischemic stroke using the Get With The Guidelines stroke database at our institute. We will be analyzing all cryptogenic stroke patients who were discharged with a Zio patch. The following data points will be collated; demographics, baseline stroke risk factors, left atrium volume, Zio patch results including wear time, analyzed time, AF burden, duration the first episode of AF detected, patient events, and other irregular arrhythmias. Our preliminary data from January 2021 to June 2022 (18 months), observed 270 cryptogenic stroke discharges. Out of which, 165 met the eligibility criteria and were discharged with a Zio patch.

Results:

AF/AFL was detected in 14 patients (8.5%). The mean duration before the first episode of paroxysmal AF (PAF) was 3.7 days and the median duration was 1.5 days. 43 percent of PAF occurred after 48 hours.

Conclusions:

The preliminary data demonstrated a relatively low yield of AF/AFL detection with Zio patch monitoring in our cryptogenic stroke population. We plan to complete the prespecified data collection period to achieve a larger sample size and further analyze independent risk factors for AF/AFL detection and patient compliance.