CRYPTOGENIC STROKE CARDIAC DIAGNOSTICS & MONITORING

THE LINK BETWEEN STROKE AND ATRIAL FIBRILLATION 

Why AF Detection and Treatment Matters for Cryptogenic Stroke Patients

2018 AHA ACUTE ISCHEMIC STROKE GUIDELINES⁶

2016 ESC Atrial Fibrillation Guidelines⁷

Long-term cardiac monitoring recommended for cryptogenic stroke patients

• Guidelines developed by the Task Force for the management of atrial fibrillation of the European Society of Cardiology (ESC)
• Developed with the special contribution of the European Heart Rhythm Association (EHRA) of the ESC
• Endorsed by the European Stroke Organisation (ESO)

30 Days of Cardiac Monitoring Is Not Long Enough in Cryptogenic Stroke Patients⁸

Atrial Fibrillation is frequently asymptomatic and/or paroxysmal

The CRYSTAL-AF Study found that short- and intermediate-term cardiac monitoring may miss many patients with paroxysmal AF.

REVEAL LINQ™ ICM Patient Selection Considerations

Indications*

• Patients with clinical syndromes or situations at increased risk of cardiac arrhythmias

Appropriate

• Stroke detected by CT or MRI that is not lacunar⁹
• Absence of extracranial or intracranial atherosclerosis causing⁹
• ≥ 50% luminal stenosis in arteries supplying the area of ischaemia⁹
• No major-risk cardioembolic source of embolism1
• No other specific cause of stroke identified (e.g., arteritis, dissection, migraine/vasospasm, drug misuse)⁹
• Any age
• First event – Stroke or High-Risk TIA**
• CHADS2 score ≥ 2 (Minimal risk factors)

Not Appropriate

• Indication for chronic anticoagulation or already on anticoagulation
• Patients with a relative contraindication for long-term anticoagulation and not appropriate for LAA closure device

^{** ABCD2 Score >5}