TY - JOUR

T1 - Atrial fibrillation in cryptogenic stroke and transient ischaemic attack - The Nordic Atrial Fibrillation and Stroke (NOR-FIB) Study

T2 - Rationale and design

AU - Ratajczak-Tretel, Barbara

AU - Lambert, Anna Tancin

AU - Johansen, Henriette

AU - Halvorsen, Bente

AU - Bjerkeli, Vigdis

AU - Russell, David

AU - Sandset, Else Charlotte

AU - Ihle-Hansen, Hege

AU - Eriksen, Erik

AU - Næss, Halvor

AU - Novotny, Vojtech

AU - Khanevski, Andrej Netland

AU - Truelsen, Thomas C

AU - Idicula, Titto

AU - Ægidius, Karen L

AU - Tobro, Håkon

AU - Krogseth, Siv B

AU - Ihle-Hansen, Håkon

AU - Hagberg, Guri

AU - Kruuse, Christina

AU - Arntzen, Kathrine

AU - Bakkejord, Grete K

AU - Villseth, Maja

AU - Nakstad, Ingvild

AU - Eldøen, Guttorm

AU - Shafiq, Raheel

AU - Gulsvik, Anne

AU - Kurz, Martin

AU - Rezai, Mehdi

AU - Sømark, Jesper

AU - Tingvoll, Stein-Helge

AU - Jonassen, Christine

AU - Ingebrigtsen, Susanne

AU - Steffensen, Linn Hofsøy

AU - Kremer, Christine

AU - Atar, Dan

AU - Aamodt, Anne Hege

PY - 2019

Y1 - 2019

N2 - Purpose: Paroxysmal atrial fibrillation is often suspected as a probable cause of cryptogenic stroke. Continuous long-term ECG monitoring using insertable cardiac monitors is a clinically effective technique to screen for atrial fibrillation and superior to conventional follow-up in cryptogenic stroke. However, more studies are needed to identify factors which can help selecting patients with the highest possibility of detecting atrial fibrillation with prolonged rhythm monitoring. The clinical relevance of short-term atrial fibrillation, the need for medical intervention and the evaluation as to whether intervention results in improved clinical outcomes should be assessed.Method: The Nordic Atrial Fibrillation and Stroke Study is an international, multicentre, prospective, observational trial evaluating the occurrence of occult atrial fibrillation in cryptogenic stroke and transient ischaemic attack. Patients with cryptogenic stroke or transient ischaemic attack from the Nordic countries are included and will have the Reveal LINQ® Insertable cardiac monitor system implanted for 12 months for atrial fibrillation detection. Biomarkers which can be used as predictors for atrial fibrillation and may identify patients, who could derive the most clinical benefit from the detection of atrial fibrillation by prolonged monitoring, are being studied.Conclusion: The primary endpoint is atrial fibrillation burden within 12 months of continuous rhythm monitoring. Secondary endpoints are atrial fibrillation burden within six months, levels of biomarkers predicting atrial fibrillation, CHA2DS2-VASc score, incidence of recurrent stroke or transient ischaemic attack, use of anticoagulation and antiarrhythmic drugs, and quality of life measurements. The clinical follow-up period is 12 months. The study started in 2017 and the completion is expected at the end of 2020.

AB - Purpose: Paroxysmal atrial fibrillation is often suspected as a probable cause of cryptogenic stroke. Continuous long-term ECG monitoring using insertable cardiac monitors is a clinically effective technique to screen for atrial fibrillation and superior to conventional follow-up in cryptogenic stroke. However, more studies are needed to identify factors which can help selecting patients with the highest possibility of detecting atrial fibrillation with prolonged rhythm monitoring. The clinical relevance of short-term atrial fibrillation, the need for medical intervention and the evaluation as to whether intervention results in improved clinical outcomes should be assessed.Method: The Nordic Atrial Fibrillation and Stroke Study is an international, multicentre, prospective, observational trial evaluating the occurrence of occult atrial fibrillation in cryptogenic stroke and transient ischaemic attack. Patients with cryptogenic stroke or transient ischaemic attack from the Nordic countries are included and will have the Reveal LINQ® Insertable cardiac monitor system implanted for 12 months for atrial fibrillation detection. Biomarkers which can be used as predictors for atrial fibrillation and may identify patients, who could derive the most clinical benefit from the detection of atrial fibrillation by prolonged monitoring, are being studied.Conclusion: The primary endpoint is atrial fibrillation burden within 12 months of continuous rhythm monitoring. Secondary endpoints are atrial fibrillation burden within six months, levels of biomarkers predicting atrial fibrillation, CHA2DS2-VASc score, incidence of recurrent stroke or transient ischaemic attack, use of anticoagulation and antiarrhythmic drugs, and quality of life measurements. The clinical follow-up period is 12 months. The study started in 2017 and the completion is expected at the end of 2020.

U2 - 10.1177/2396987319837089

DO - 10.1177/2396987319837089

M3 - Journal article

C2 - 31259265

VL - 4

SP - 172

EP - 180

JO - European Stroke Journal

JF - European Stroke Journal

SN - 2396-9873

IS - 2

ER -