open access

Vol 53, No 3 (2019)
Review article
Published online: 2019-05-28
Submitted: 2019-03-30
Accepted: 2019-05-12
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Statement by a Working Group conceived by the Polish National Consultants in Cardiology and Neurology addressing the use of implantable cardiac monitors in patients after ischaemic embolic stroke of undetermined source

Michał M. Farkowski, Michał A. Karliński, Jarosław Kaźmierczak, Piotr Kułakowski, Przemysław Mitkowski, Paweł Ptaszyński, Danuta Ryglewicz, Jarosław Sławek, Agnieszka Słowik, Maciej Sterliński
DOI: 10.5603/PJNNS.a2019.0018
·
Pubmed: 31145466
·
Neurol Neurochir Pol 2019;53(3):181-189.

open access

Vol 53, No 3 (2019)
Review article
Published online: 2019-05-28
Submitted: 2019-03-30
Accepted: 2019-05-12

Abstract

Introduction. Stroke remains one of the main causes of death and the most common cause of long-term disability in adults. Embolic strokes of undetermined source (ESUS) amount to a significant proportion of all ischaemic strokes. Detection of atrial fibrillation (AF) in this group of patients would allow for a major therapeutic decision to switch from antiplatelets to oral anticoagulants and therefore significantly reduce the risk of recurrence.

State of the Art. Current technology allows long-term continuous ECG monitoring with different systems, including implantable cardiac monitors (ICM). However, in Poland lack of reimbursement does not allow their use in everyday clinical practice.

Clinical Implications. This is a statement by a Working Group conceived by the Polish National Consultants in Cardiology and Neurology addressing the use of ICM in patients after ischaemic embolic strokes of undetermined source. The aim was to develop reasonable and comprehensive guidance on how to select and manage candidates for ICM in order to obtain the maximum benefit for Polish public health.

Future Directions. This expert opinion is not intended as a guideline but it provides advice as to how to optimise the potential use of ICM in patients after ESUS in the Polish setting.

Abstract

Introduction. Stroke remains one of the main causes of death and the most common cause of long-term disability in adults. Embolic strokes of undetermined source (ESUS) amount to a significant proportion of all ischaemic strokes. Detection of atrial fibrillation (AF) in this group of patients would allow for a major therapeutic decision to switch from antiplatelets to oral anticoagulants and therefore significantly reduce the risk of recurrence.

State of the Art. Current technology allows long-term continuous ECG monitoring with different systems, including implantable cardiac monitors (ICM). However, in Poland lack of reimbursement does not allow their use in everyday clinical practice.

Clinical Implications. This is a statement by a Working Group conceived by the Polish National Consultants in Cardiology and Neurology addressing the use of ICM in patients after ischaemic embolic strokes of undetermined source. The aim was to develop reasonable and comprehensive guidance on how to select and manage candidates for ICM in order to obtain the maximum benefit for Polish public health.

Future Directions. This expert opinion is not intended as a guideline but it provides advice as to how to optimise the potential use of ICM in patients after ESUS in the Polish setting.

Get Citation

Keywords

acute ischaemic stroke, embolic stroke of undetermined source, atrial fibrillation, ECG monitoring

About this article
Title

Statement by a Working Group conceived by the Polish National Consultants in Cardiology and Neurology addressing the use of implantable cardiac monitors in patients after ischaemic embolic stroke of undetermined source

Journal

Neurologia i Neurochirurgia Polska

Issue

Vol 53, No 3 (2019)

Pages

181-189

Published online

2019-05-28

DOI

10.5603/PJNNS.a2019.0018

Pubmed

31145466

Bibliographic record

Neurol Neurochir Pol 2019;53(3):181-189.

Keywords

acute ischaemic stroke
embolic stroke of undetermined source
atrial fibrillation
ECG monitoring

Authors

Michał M. Farkowski
Michał A. Karliński
Jarosław Kaźmierczak
Piotr Kułakowski
Przemysław Mitkowski
Paweł Ptaszyński
Danuta Ryglewicz
Jarosław Sławek
Agnieszka Słowik
Maciej Sterliński

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