Asymptomatic Atrial Fibrillation Relatively Common In Cryptogenic Stroke Interview with:
Dr. Tommaso Sanna MD
Institute of Cardiology
Catholic University of the Sacred Heart
Rome, Italy

MedicalResearch: What are the main findings of the study?

Dr. Sanna: In patients with cryptogenic stroke, continuous ECG monitoring with an implantable device, called the Reveal XT Insertable Cardiac Monitor (ICM), discovered Atrial Fibrillation in 6.4 times more patients than conventional diagnostic strategies at six months, 7.3 times more patients at 12 months, and 8.8 times more patients at 36 months. In more detail, after 36 months of follow-up, 30% of patients with cryptogenic stroke had at least one episode of atrial fibrillation.

MedicalResearch: Were any of the findings unexpected?

Dr. Sanna: Nearly 80% of the episodes were asymptomatic and therefore impossible to detect with symptom-based diagnostic strategies.

MedicalResearch: What should clinicians and patients take away from your report?

Dr. Sanna: The detection of atrial fibrillation in patients with previous ischemic stroke is a strong risk factor for stroke recurrence, and should prompt clinicians to prescribe anticoagulant treatment.

MedicalResearch: What recommendations do you have for future research as a result of this study?

Dr. Sanna: Future research should be addressed to identify patients who benefit most from long term monitoring and to better understand the relation between Atrial Fibrillation detection, Atrial Fibrillation duration and stroke recurrence.


Cryptogenic Stroke and Underlying Atrial Fibrillation
Tommaso Sanna, M.D., Hans-Christoph Diener, M.D., Ph.D., Rod S. Passman, M.D., M.S.C.E., Vincenzo Di Lazzaro, M.D., Richard A. Bernstein, M.D., Ph.D., Carlos A. Morillo, M.D., Marilyn Mollman Rymer, M.D., Vincent Thijs, M.D., Ph.D., Tyson Rogers, M.S., Frank Beckers, Ph.D., Kate Lindborg, Ph.D., and Johannes Brachmann, M.D. for the CRYSTAL AF Investigators

N Engl J Med 2014; 370:2478-2486June 26, 2014DOI: 10.1056/NEJMoa1313600


Last Updated on July 1, 2014 by Marie Benz MD FAAD