Advanced

Atrial fibrillation in cryptogenic stroke and transient ischaemic attack – The Nordic Atrial Fibrillation and Stroke (NOR-FIB) Study : Rationale and design

Ratajczak-Tretel, Barbara; Lambert, Anna Tancin; Johansen, Henriette; Halvorsen, Bente; Bjerkeli, Vigdis; Russell, David; Sandset, Else Charlotte; Ihle-Hansen, Hege; Eriksen, Erik and Næss, Halvor, et al. (2019) In European Stroke Journal 4(2). p.172-180
Abstract


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.... (More)


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, CHA
2
DS
2
-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.

(Less)
Please use this url to cite or link to this publication:
author
, et al. (More)
(Less)
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
anticoagulation, arrhythmia monitoring, atrial fibrillation, biomarkers, Cryptogenic stroke, insertable cardiac monitor, Nordic Atrial Fibrillation and Stroke Study
in
European Stroke Journal
volume
4
issue
2
pages
172 - 180
publisher
SAGE Publications Inc.
external identifiers
  • scopus:85063332444
ISSN
2396-9873
DOI
10.1177/2396987319837089
language
English
LU publication?
yes
id
541efad3-ec9a-4f97-8154-43b57dd933a9
date added to LUP
2019-04-05 13:56:03
date last changed
2019-06-28 10:46:45
@article{541efad3-ec9a-4f97-8154-43b57dd933a9,
  abstract     = {<p><br>
                                                         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, CHA                             <br>
                            <sub>2</sub><br>
                                                         DS                             <br>
                            <sub>2</sub><br>
                                                         -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.                         <br>
                        </p>},
  author       = {Ratajczak-Tretel, Barbara and Lambert, Anna Tancin and Johansen, Henriette and Halvorsen, Bente and Bjerkeli, Vigdis and Russell, David and Sandset, Else Charlotte and Ihle-Hansen, Hege and Eriksen, Erik and Næss, Halvor and Novotny, Vojtech and Khanevski, Andrej Netland and Truelsen, Thomas C. and Idicula, Titto and Ægidius, Karen L. and Tobro, Håkon and Krogseth, Siv B. and Ihle-Hansen, Håkon and Hagberg, Guri and Kruuse, Christina and Arntzen, Kathrine and Bakkejord, Grete K. and Villseth, Maja and Nakstad, Ingvild and Eldøen, Guttorm and Shafiq, Raheel and Gulsvik, Anne and Kurz, Martin and Rezai, Mehdi and Sømark, Jesper and Tingvoll, Stein Helge and Jonassen, Christine and Ingebrigtsen, Susanne and Steffensen, Linn Hofsøy and Kremer, Christine and Atar, Dan and Aamodt, Anne Hege},
  issn         = {2396-9873},
  keyword      = {anticoagulation,arrhythmia monitoring,atrial fibrillation,biomarkers,Cryptogenic stroke,insertable cardiac monitor,Nordic Atrial Fibrillation and Stroke Study},
  language     = {eng},
  number       = {2},
  pages        = {172--180},
  publisher    = {SAGE Publications Inc.},
  series       = {European Stroke Journal},
  title        = {Atrial fibrillation in cryptogenic stroke and transient ischaemic attack – The Nordic Atrial Fibrillation and Stroke (NOR-FIB) Study : Rationale and design},
  url          = {http://dx.doi.org/10.1177/2396987319837089},
  volume       = {4},
  year         = {2019},
}