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The present study is an investigator-initiated, single-center, retrospective study based on data from the London Ontario Stroke Registry (LOSR), aiming to compare the characteristics and outcomes of ECG-detected and Device-Detected atrial fibrillation in patients with ischemic stroke and transient ischemic attack.
Patients with ischemic stroke and transient ischemic attack (TIA) without known atrial fibrillation (AF) are investigated with Prolonged Cardiac Monitoring (PCM) to detect AF. It is unclear if AF detected on 12-lead ECG after stroke occurrence bears the same risk of stroke as Device-detected AF. The investigators hypothesize, that Device-detected AF has a lower risk of ischemic stroke recurrence. The investigators will conduct a retrospective analysis of prospectively collected data from consecutive patients enrolled in the London Ontario Stroke Registry, (Ontario, Canada). The primary outcome will be a recurrent ischemic stroke at the end of the available follow-up window. The investigators will include ischemic stroke and TIA patients with ECG-detected AF and those with Device-detected AF on at least 7 days of Holter monitoring.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| ECG-Detected AF | Patients with atrial fibrillation detected on 12-lead ECGs done post-stroke |
| |
| Device-Detected AF | Patients with atrial fibrillation detected on prolonged Holter monitoring lasting at least 7 days. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Prolonged cardiac monitoring | Diagnostic Test | Prolonged cardiac monitoring |
| |
| Measure | Description | Time Frame |
|---|---|---|
| Number of Participants with Recurrent Ischemic Stroke at End of available Follow-up Time | Documented recurrent ischemic stroke | Duration of follow-up - minimum of 3 months after the first encounter with the stroke team |
| Measure | Description | Time Frame |
|---|---|---|
| Death | Number of patients dead at the end of the available follow-up | Duration of follow-up - minimum of 3 months after the first encounter with the stroke team |
| Readmission for decompensated AF or heart failure |
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Inclusion Criteria:
Exclusion Criteria:
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Patients with an acute ischemic stroke or TIA in the London Ontario Stroke Registry without known AF, who are newly diagnosed with AF on a 12-lead ECG or a ≥7-day external cardiac monitor.
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| Name | Affiliation | Role |
|---|---|---|
| Luciano Sposato, MD, MBA (PI) | London Health Sciences Centre, Western University (London, ON. Canada) | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Heart & Brain Lab, Western University | London | Ontario | N6A 5A5 | Canada |
Individual patients data will be made available upon reasonable request, conditional to approval from Western University Ethics Review Board
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| ECG |
| Diagnostic Test |
Electrocardiogram |
|
Prevalence of readmission for decompensated AF or heart failure (HF) in each group
| Duration of follow-up - minimum of 3 months after the first encounter with the stroke team |
| Prevalence of risk factors, cardiovascular comorbidities, and structural heart disease | Proportion with vascular risk factors, cardiovascular comorbidities, and structural heart disease in each group | Documented at baseline. |
| ID | Term |
|---|---|
| D020521 | Stroke |
| D001281 | Atrial Fibrillation |
| ID | Term |
|---|---|
| D002561 | Cerebrovascular Disorders |
| D001927 | Brain Diseases |
| D002493 | Central Nervous System Diseases |
| D009422 | Nervous System Diseases |
| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |
| D001145 | Arrhythmias, Cardiac |
| D006331 | Heart Diseases |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
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| ID | Term |
|---|---|
| D004562 | Electrocardiography |
| ID | Term |
|---|---|
| D006334 | Heart Function Tests |
| D003935 | Diagnostic Techniques, Cardiovascular |
| D019937 | Diagnostic Techniques and Procedures |
| D003933 | Diagnosis |
| D004568 | Electrodiagnosis |
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