From Detection to Decision: Managing Device-Detected Atrial Fibrillation After Stroke.

IF 7.4 2区医学 Q1 CLINICAL NEUROLOGY

Current Neurology and Neuroscience Reports Pub Date : 2025-12-18 DOI:10.1007/s11910-025-01473-z

Nadja Korajkic, Vincent Thijs

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引用次数: 0

Abstract

Purpose of review: To summarise contemporary strategies to detect atrial fibrillation (AF) after stroke/transient ischemic attack (TIA) with emphasis on implantable loop recorders (ILRs), evaluate who should receive anticoagulation in device detected AF/atrial high-rate episodes, and evaluate biomarkers that increase the likelihood of detecting AF.

Recent findings: ILRs substantially increase AF detection beyond 12-36 months of monitoring. General population screening with ILRs increases AF diagnosis without a definitive stroke reduction. For subclinical/device detected AF, anticoagulation may reduce stroke but comes at the expense of increased bleeding. The burden of AF, biomarkers and atrial cardiomyopathy markers show promise to stratify risk and guide extended monitoring. An individualized approach is needed to identify who benefits most from ILR and subsequent anticoagulation. Research priorities include outcome-powered trials after stroke/TIA, the role of AF burden in decision making and the role of wearables within clinical pathways.

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从检测到决策：处理卒中后设备检测心房颤动。

综述的目的：总结当代检测卒中/短暂性脑缺血发作（TIA）后房颤（AF）的策略，重点是植入式环路记录仪（ILRs），评估在检测到AF/心房高发生率发作的设备中谁应该接受抗凝治疗，并评估增加AF检测可能性的生物标志物。最近的研究发现：ILRs在监测12-36个月后显著增加了AF的检测。一般人群的ILRs筛查增加了房颤诊断，但没有明确减少卒中。对于亚临床/设备检测到的房颤，抗凝可以减少卒中，但以增加出血为代价。房颤的负担、生物标志物和心房心肌病标志物显示出对风险分层和指导扩大监测的希望。需要个体化的方法来确定谁从ILR和随后的抗凝治疗中获益最多。研究重点包括卒中/TIA后的结果驱动试验，AF负担在决策中的作用以及可穿戴设备在临床途径中的作用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Current Neurology and Neuroscience Reports 医学-临床神经学

CiteScore

9.20

自引率

0.00%

发文量

审稿时长

6-12 weeks

期刊介绍： Current Neurology and Neuroscience Reports provides in-depth review articles contributed by international experts on the most significant developments in the field. By presenting clear, insightful, balanced reviews that emphasize recently published papers of major importance, the journal elucidates current and emerging approaches to the diagnosis, treatment, management, and prevention of neurological disease and disorders. Presents the views of experts on current advances in neurology and neuroscience Gathers and synthesizes important recent papers on the topic Includes reviews of recently published clinical trials, valuable web sites, and commentaries from well-known figures in the field.