Po-03-061 utility of implantable loop recorders for cryptogenic strokes to detect arrhythmias other than atrial fibrillation

Implantable loop recorders (ILR) are recommended to detect atrial fibrillation (AF) in cases of cryptogenic stroke (CS). However, the utilization of loop recorders for the diagnosis of other arrhythmias in patients with a history of cryptogenic stroke is limited. To evaluate the utility of ILR to detect arrhythmias other than AF in patients with cryptogenic stroke. We enrolled consecutive CS patients referred for an ILR. A retrospective chart review was conducted from 2018 to 2021. All patients were monitored for a minimum of one year. The cohort included 260 consecutive patients with cryptogenic stroke with a mean age of 68. AF was found in 53 (20%) patients and 44 (17%) patients were found to have other arrhythmias. 23 patients (9%) were found to have supraventricular tachycardias (SVT), 4 patients (2%) had ventricular tachycardias, 9 patients (3%) had pauses, 8 patients (3%) had significant bradycardias. Anticoagulation was initiated in 51 patients (20%). A total of 14 patients (5%) underwent procedures (7 pacemakers, 1 SVT ablation, 6 electrophysiology studies) because of ILR findings. Of the patients who underwent procedures, 7 did not have AF. ILRs can successfully identify AF in patients with cryptogenic stroke. However, there is a high incidence of other arrhythmias that can be detected by implanting ILRs that otherwise would not be identified. The study demonstrates the importance of long-term remote monitoring of patients with CS for the detection of not just AF but other conduction disorders as well, some of which require device implants and ablations.