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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
, 2, 3, 4, 5, 6, 2, 7, 8, 1
Affiliations- Institute of Cardiology, Alpejska 42, 04-628 Warsaw, Poland
- 2nd Department of Neurology Institute of Psychiatry and Neurology, Warsaw, Poland
- Pomeranian Medical University, Poland
- Postgraduate Medical Education Center, Warsaw, Poland
- Poznan University of Medical Sciences, Poland
- Medical University of Lodz, Poland
- Medical University of Gdansk, Poland
- Jagiellonian University Medical College, Cracow, Poland
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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.
Keywords
acute ischaemic stroke, embolic stroke of undetermined source, atrial fibrillation, ECG monitoring
About this articleTitle
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
Article type
Review Article
Pages
181-189
Published online
2019-05-28
Page views
1372
Article views/downloads
1060
DOI
Pubmed
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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