Do not use implantable loop recorders in asymptomatic patients at high risk of stroke as a screening tool for atrial fibrillation.

Oct 17, 2018

Do not use implantable loop recorders in asymptomatic patients at high risk of stroke as a screening tool for atrial fibrillation.

Type of practice

Cardiological tests

Age

Adult, Geriatric

Topic Area

Clinical Pharmacy and Therapy

The clinical impact of diagnosing atrial fibrillation (AF) in asymptomatic individuals through screening programs remains not fully established, as current literature has not consistently demonstrated a reduction in thrombotic events. Furthermore, the patient populations most likely to benefit from screening, the optimal type of monitoring device, the best methods for conducting screening, and the effect of screening on stroke prevention have yet to be clearly defined. The role of implantable loop recorders should also be reconsidered in light of the rapid technological advancements and increasing performance of wearable devices.

Sources

1. Van Gelder IC, Rienstra M, Bunting KV et al. 2024 ESC Guidelines for the management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS). Eur Heart J. 2024;45:3314-3414. doi: 10.1093/eurheartj/ehae176.
2. Svendsen JH, Diederichsen SZ, Højberg S et al. Implantable loop recorder detection of atrial fibrillation to prevent stroke (The LOOP Study): a randomised controlled trial. Lancet. 2021;398:1507-1516. doi: 10.1016/S0140-6736(21)01698-6.
3. Svennberg E, Tjong F, Goette A et al. How to use digital devices to detect and manage arrhythmias: an EHRA practical guide. Europace. 2022;24:979-1005. doi: 10.1093/europace/euac038.
4. Dlima J, Kitisarn R, Lim H et al. Is there a temporal relationship between atrial fibrillation and stroke? A review. BMJ Neurol Open. 2024;6:e000512. doi: 10.1136/bmjno-2023-000512.
5. Spatz ES, Ginsburg GS, Rumsfeld JS, Turakhia MP. Wearable Digital Health Technologies for Monitoring in Cardiovascular Medicine. N Engl J Med. 2024;390: 346-356. doi: 10.1056/NEJMra2301903.

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