SmartWatch-driven AF Detection in Stroke Patients

Prior treatment

• Patient not willing to be treated with oral anticoagulants vii. Carotid artery stenosis ipsilateral to the current ischemic stroke needing operation or intervention.

Other illness

• Exclusion criteria of the Find-AF 2 study (according to protocol version Final 4.0, dated 08.05.2024):
  • Known history of atrial fibrillation/flutter or atrial fibrillation/flutter on admission ECG.
• Intracerebral bleeding in medical history iv. Patient scheduled for ECG-monitoring lasting \> 7 days (Holter-ECG, implanted loop recorder, etc.).
• Implanted pacemaker device or cardioverter/defibrillator or implanted cardiac monitor.
• History of carotid endarterectomy or percutaneous stent intervention of cerebral or cervical artery within the last 30 days.
• Life expectancy \<1 year for reasons other than stroke (e.g. metastatic cancer).
• Patients under legal supervision or guardianship xi. Psychological/mental or other inabilities to supply required information (e.g. fill out the questionnaire due to dementia, language difficulties, ... ) or participate in the required tests xii. Participation in other randomized interventional trials xiii. Suspected lack of compliance

Other

• Expiration of the battery of the event recorder in \<3 months
• No in ICM data transmission possible (e. g. missing compliance)
• Poor ECG data quality according to core lab evaluation (e.g. permanent oversensing), which prevents meaningful evaluation of the event recorder data
• Current indication or contraindication for oral anticoagulation at randomisation.

• Study participation in Find-AF 2
• Randomization in the intervention arm of the Find-AF 2 study and presence of an implanted event recorder (Medtronic Reveal LINQTM Insertable Cardiac Monitor)
• Signed informed consent
• All inclusion criteria of the Find-AF 2 study are met (according to protocol version Final 4.0, dated 08.05.2024):
  • Recent symptomatic ischemic stroke within the last 30 days (sudden focal neurologic deficit lasting \> 24 h consistent with the territory of a cerebral artery) If the neurologic deficit lasted \< 24 h a corresponding lesion\* on brain imaging is needed.
• Age ≥ 60 years. iii. Patient without or with only slight disability (modified Rankin Scale score ≤ 2) before onset of stroke-related symtoms.
• Written informed consent
  • \* Corresponding lesion can be an acute lesion on diffusion-weighted magnetic resonance imaging, native computed tomography (CT) or CT perfusion imaging or a recent occlusion or intracranial thrombus on angiography (CTA, MRA, DSA)