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Monitoring for atrial fibrillation prior to patent foramen ovale closure after cryptogenic stroke

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Monitoring for atrial fibrillation prior to patent foramen ovale closure after cryptogenic stroke. / Diener, Hans-Christoph; Wachter, Rolf; Wong, Andrew; Thijs, Vincent; Schnabel, Renate B; Ntaios, George; Kasner, Scott; Rothwell, Peter M; Passman, Rod; Saver, Jeffrey L; Albers, Bert A; Bernstein, Richard A.

in: INT J STROKE, Jahrgang 18, Nr. 4, 04.2023, S. 400-407.

Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Review › Forschung

Harvard

Diener, H-C, Wachter, R, Wong, A, Thijs, V, Schnabel, RB, Ntaios, G, Kasner, S, Rothwell, PM, Passman, R, Saver, JL, Albers, BA & Bernstein, RA 2023, 'Monitoring for atrial fibrillation prior to patent foramen ovale closure after cryptogenic stroke', INT J STROKE, Jg. 18, Nr. 4, S. 400-407. https://doi.org/10.1177/17474930221124412

APA

Diener, H-C., Wachter, R., Wong, A., Thijs, V., Schnabel, R. B., Ntaios, G., Kasner, S., Rothwell, P. M., Passman, R., Saver, J. L., Albers, B. A., & Bernstein, R. A. (2023). Monitoring for atrial fibrillation prior to patent foramen ovale closure after cryptogenic stroke. INT J STROKE, 18(4), 400-407. https://doi.org/10.1177/17474930221124412

Vancouver

Diener H-C, Wachter R, Wong A, Thijs V, Schnabel RB, Ntaios G et al. Monitoring for atrial fibrillation prior to patent foramen ovale closure after cryptogenic stroke. INT J STROKE. 2023 Apr;18(4):400-407. https://doi.org/10.1177/17474930221124412

Bibtex

@article{b85a307b08414a529b2a1a327fb5e618,
title = "Monitoring for atrial fibrillation prior to patent foramen ovale closure after cryptogenic stroke",
abstract = "BACKGROUND: Patients who had a cryptogenic stroke (CS) suspected to be causally related to a patent foramen ovale (PFO) are candidates for percutaneous PFO closure. In such patients, it is important to screen for atrial fibrillation (AF). Limited guidance is available regarding AF monitoring strategies in CS patients with PFO addressing optimal monitoring technology and duration.AIM: To provide a narrative review of cardiac rhythm monitoring in CS patients considered for PFO closure, including current practices, stroke recurrences after CS, findings from monitoring studies in CS patients, and predictors for AF detection published in the literature. To propose a personalized strategy for cardiac monitoring in CS patients, accounting for aspects predicting AF detection.SUMMARY OF REVIEW: AF detection in CS patients is predicted by age, left atrial enlargement, prolonged PR interval, frequent premature atrial contractions, interatrial conduction block, diabetes, prior brain infarctions, leukoaraiosis, elevated B-type natriuretic peptide (BNP)/N-terminal pro B-type natriuretic peptide (NT-proBNP) levels, and a family history of AF, as well as composed scores (e.g. CHA2DS2-VASc, atrial fibrillation in embolic stroke of undetermined source (AF-ESUS)). The causal role of the PFO may be accounted for by the risk of paradoxical embolism (RoPE) score and/or the PFO-Associated Stroke Causal Likelihood (PASCAL) classification.CONCLUSION: A personalized approach to AF detection in CS patients is proposed, accounting for the likelihood of AF detection and aimed at obtaining sufficient confidence regarding the absence of AF in patients considered for PFO closure. In addition, the impact of high-risk PFO features on the monitoring strategy is discussed.",
author = "Hans-Christoph Diener and Rolf Wachter and Andrew Wong and Vincent Thijs and Schnabel, {Renate B} and George Ntaios and Scott Kasner and Rothwell, {Peter M} and Rod Passman and Saver, {Jeffrey L} and Albers, {Bert A} and Bernstein, {Richard A}",
year = "2023",
month = apr,
doi = "10.1177/17474930221124412",
language = "English",
volume = "18",
pages = "400--407",
journal = "INT J STROKE",
issn = "1747-4930",
publisher = "Wiley-Blackwell",
number = "4",

}

RIS

TY - JOUR

T1 - Monitoring for atrial fibrillation prior to patent foramen ovale closure after cryptogenic stroke

AU - Diener, Hans-Christoph

AU - Wachter, Rolf

AU - Wong, Andrew

AU - Thijs, Vincent

AU - Schnabel, Renate B

AU - Ntaios, George

AU - Kasner, Scott

AU - Rothwell, Peter M

AU - Passman, Rod

AU - Saver, Jeffrey L

AU - Albers, Bert A

AU - Bernstein, Richard A

PY - 2023/4

Y1 - 2023/4

N2 - BACKGROUND: Patients who had a cryptogenic stroke (CS) suspected to be causally related to a patent foramen ovale (PFO) are candidates for percutaneous PFO closure. In such patients, it is important to screen for atrial fibrillation (AF). Limited guidance is available regarding AF monitoring strategies in CS patients with PFO addressing optimal monitoring technology and duration.AIM: To provide a narrative review of cardiac rhythm monitoring in CS patients considered for PFO closure, including current practices, stroke recurrences after CS, findings from monitoring studies in CS patients, and predictors for AF detection published in the literature. To propose a personalized strategy for cardiac monitoring in CS patients, accounting for aspects predicting AF detection.SUMMARY OF REVIEW: AF detection in CS patients is predicted by age, left atrial enlargement, prolonged PR interval, frequent premature atrial contractions, interatrial conduction block, diabetes, prior brain infarctions, leukoaraiosis, elevated B-type natriuretic peptide (BNP)/N-terminal pro B-type natriuretic peptide (NT-proBNP) levels, and a family history of AF, as well as composed scores (e.g. CHA2DS2-VASc, atrial fibrillation in embolic stroke of undetermined source (AF-ESUS)). The causal role of the PFO may be accounted for by the risk of paradoxical embolism (RoPE) score and/or the PFO-Associated Stroke Causal Likelihood (PASCAL) classification.CONCLUSION: A personalized approach to AF detection in CS patients is proposed, accounting for the likelihood of AF detection and aimed at obtaining sufficient confidence regarding the absence of AF in patients considered for PFO closure. In addition, the impact of high-risk PFO features on the monitoring strategy is discussed.

AB - BACKGROUND: Patients who had a cryptogenic stroke (CS) suspected to be causally related to a patent foramen ovale (PFO) are candidates for percutaneous PFO closure. In such patients, it is important to screen for atrial fibrillation (AF). Limited guidance is available regarding AF monitoring strategies in CS patients with PFO addressing optimal monitoring technology and duration.AIM: To provide a narrative review of cardiac rhythm monitoring in CS patients considered for PFO closure, including current practices, stroke recurrences after CS, findings from monitoring studies in CS patients, and predictors for AF detection published in the literature. To propose a personalized strategy for cardiac monitoring in CS patients, accounting for aspects predicting AF detection.SUMMARY OF REVIEW: AF detection in CS patients is predicted by age, left atrial enlargement, prolonged PR interval, frequent premature atrial contractions, interatrial conduction block, diabetes, prior brain infarctions, leukoaraiosis, elevated B-type natriuretic peptide (BNP)/N-terminal pro B-type natriuretic peptide (NT-proBNP) levels, and a family history of AF, as well as composed scores (e.g. CHA2DS2-VASc, atrial fibrillation in embolic stroke of undetermined source (AF-ESUS)). The causal role of the PFO may be accounted for by the risk of paradoxical embolism (RoPE) score and/or the PFO-Associated Stroke Causal Likelihood (PASCAL) classification.CONCLUSION: A personalized approach to AF detection in CS patients is proposed, accounting for the likelihood of AF detection and aimed at obtaining sufficient confidence regarding the absence of AF in patients considered for PFO closure. In addition, the impact of high-risk PFO features on the monitoring strategy is discussed.

U2 - 10.1177/17474930221124412

DO - 10.1177/17474930221124412

M3 - SCORING: Review article

C2 - 36050817

VL - 18

SP - 400

EP - 407

JO - INT J STROKE

JF - INT J STROKE

SN - 1747-4930

IS - 4

ER -