Please select the option that best describes you:
For which stroke patients, if any, do you recommend implantable loop recorder for long-term cardiac monitoring and why?
It seems clear that longer monitoring yields more AF detected. What is less clear to me is whether all ILR-detected AF is relevant and merits anticoagulation. The recent LOOP study is the first study to my knowledge with stroke reduction as a primary endpoint and showed no benefit despite high rates of detected AF and anticoagulant use.
Answer from: at Academic Institution
The term embolic stroke of unknown source, or ESUS, implies an embolic type of stroke, i.e., sudden onset, cortical subcortical distribution, not lacunar, and with no demonstrated atherosclerosis either in the carotids or intracranially. Since we suspect a source of embolism, further evaluation with...
Answer from: at Academic Institution
The question was framed as ESUS; i.e., embolic stroke. Typically, neurologists adjudicate whether a stroke is "embolic" or not but my experience is that younger neurologists rarely use the term "lacunar". Thus, if the stroke is clearly NOT due to atherosclerosis of the major intracranial vessels, th...
Answer from: at Community Practice
I usually consider ILR in patients stratified to high risk for PAF with suspected embolic stroke with so far negative workup for embolic causes including atherosclerotic disease (e.g., SYNC, aortic arch evaluation, athero embolism from mild to moderate intracranial stenosis), structural and culprit ...
Comments
at Lee Health
I’ll consult cardiology to place a loop reco...
I’ll consult cardiology to place a loop reco...
Thanks for the thoughtful analysis, Dr. @Havenon! ...