Impact of Standardized MONitoring for Detection of Atrial Fibrillation in Ischemic Stroke

Conditions

Atrial Fibrillation, Stroke

Keywords

Stroke, atrial fibrillation, ECG

Brief summary

Investigator-initiated prospective randomized multicentre study to uncover the true burden of paroxysmal atrial fibrillation in a representative population of acute stroke patients without known atrial fibrillation.

Karl Georg Hæusler, Serdar Tütüncü, Cornelia Fießler, Muhammad Jawad‐Ul‐Qamar, Claudia Kunze et al. (20 authors)

Journal of the American Heart Association2025-01-103 citations

10.1161/jaha.123.034512

The Role of Atrial Fibrillation and Oral Anticoagulation Status in Health‐Related Quality of Life 12 Months After Ischemic Stroke or TIA

Manuel C. Olma, Lena Steindorf‐Sabath, Serdar Tütüncü, Claudia Kunze, Cornelia Fießler et al. (20 authors)

Brain and Behavior2025-01-011 citations

10.1002/brb3.70248

Heart failure, recurrent vascular events and death in patients with ischemic stroke-results of the MonDAFIS study.

Tütüncü S, Olma MC, Kunze C, Dietzel J, Schurig J, Rosenkranz M, Stingele R, Maschke M, Heuschmann PU, Kirchhof P, Laufs U, Nabavi DG, Röther J, Thomalla G, Veltkamp R, Endres M, Haeusler KG, MonDAFIS Investigators.

2024-04-15

10.1007/s11739-024-03594-8

Independent external validation of a stroke recurrence score in patients with embolic stroke of undetermined source.

Ingwersen T, Olma MC, Schlemm E, Mayer C, Cheng B, Tütüncü S, Kirchhof P, Veltkamp R, Röther J, Laufs U, Nabavi DG, Ntaios G, Endres M, Haeusler KG, Thomalla G.

2023-10-05

10.1186/s42466-023-00279-z

Extent of routine diagnostic cardiac work-up at certified German stroke units participating in the prospective MonDAFIS study

Manuel C. Olma, Serdar Tütüncü, Ulrike Grittner, Claudia Kunze, Muhammad Jawad‐Ul‐Qamar et al. (14 authors)

Neurological Research and Practice2023-06-012 citations

10.1186/s42466-023-00246-8

In‐Hospital ECG Findings, Changes in Medical Management, and Cardiovascular Outcomes in Patients With Acute Stroke or Transient Ischemic Attack

Manuel C. Olma, Serdar Tütüncü, Cornelia Fießler, Claudia Kunze, Michael D. Kramer et al. (73 authors)

Journal of the American Heart Association2023-01-119 citations

10.1161/jaha.122.027149

Systematic monitoring for detection of atrial fibrillation in patients with acute ischaemic stroke (MonDAFIS): a randomised, open-label, multicentre study.

Haeusler KG, Kirchhof P, Kunze C, Tütüncü S, Fiessler C, Malsch C, Olma MC, Jawad-Ul-Qamar M, Krämer M, Wachter R, Michalski D, Kraft A, Rizos T, Gröschel K, Thomalla G, Nabavi DG, Röther J, Laufs U, Veltkamp R, Heuschmann PU, Endres M, MonDAFIS Investigators.

2021-06-0159 citations

10.1016/s1474-4422(21)00067-3

HEart and BRain interfaces in Acute ischemic Stroke (HEBRAS)--rationale and design of a prospective oberservational cohort study.

Haeusler KG, Grittner U, Fiebach JB, Endres M, Krause T, Nolte CH.

2015-10-2210 citations

10.1186/s12883-015-0458-2

Interventions

OTHERprolonged ECG monitoring

Start of long-term ECG immediately after admission to the stroke unit by using a portable ECG recorder for a max. duration of 7 days (or hospital discharge)

DEVICEECG

Study design

Allocation

RANDOMIZED

Intervention model

PARALLEL

Primary purpose

DIAGNOSTIC

Masking

NONE

Eligibility

Sex/Gender

ALL

Age

18 Years to No maximum

Healthy volunteers

No

Inclusion criteria

* Acute ischemic stroke or transitory ischemic attack (with clinical deficit on enrolment or MRI detected acute brain lesion on admission) * Age ≥ 18 years * Written or oral informed consent * Stroke unit admission within 72 hours after stroke onset * Start of standardized prolonged ECG monitoring within 24 hours after admission to the stroke unit * Willingness to take part in the planned follow up examinations

Exclusion criteria

* Known atrial fibrillation * Atrial fibrillation detected by ECG on admission * Atrial fibrillation detected prior study enrollment on the stroke unit * Life expectancy \< 1 year (before actual stroke) * Life expectancy \< 1 month (after actual stroke) * Indication for oral anticoagulation other than atrial fibrillation (e.g. mechanical heart valve) * Severity level according National Institute of Health Stroke Scale (NIHSS) score \> 22 * Participation in an interventional trial

Design outcomes

Primary

Measure	Time frame	Description
Number of patients on oral anticoagulation (NOAC or VKA)	12 months	Number of study patients on oral anticoagulation (NOAC or VKA) at 12 months after the index stroke either randomized to standardized prolonged ECG monitoring in-hospital or those randomized to usual stroke unit diagnostic procedures alone.

Secondary

Measure	Time frame	Description
Number of stroke patients with newly detected atrial fibrillation	7 days	Number of stroke patients with newly detected atrial fibrillation using a standardized prolonged ECG monitoring compared to usual stroke unit diagnostic procedures alone.

Other

Measure	Time frame	Description
Impact of stroke unit level on the rate of atrial fibrillation detection	7 days	Impact of stroke unit level (i.e. primary or comprehensive stroke center) on the rate of atrial fibrillation detection in-hospital stroke in patients randomized to standardized prolonged ECG monitoring in hospital
Number of recurrent strokes, major bleeds, myocardial infarction and all-cause death (composite endpoint) within 6, 12 and 24 months after the index stroke	24 months	Number of recurrent strokes, major bleeds, myocardial infarction and all-cause death (composite endpoint) within 6, 12 and 24 months after the index stroke in patients either randomized to standardized prolonged ECG monitoring in-hospital or those randomized to usual stroke unit diagnostic procedures alone.

Countries

Germany

Outcome results

None listed