{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T04:36:45Z","timestamp":1784695005669,"version":"3.55.0"},"reference-count":13,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2020,6,29]],"date-time":"2020-06-29T00:00:00Z","timestamp":1593388800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2020,6,29]],"date-time":"2020-06-29T00:00:00Z","timestamp":1593388800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Ministerium f\u00fcr Wirtschaft, Arbeit und Gesundheit Mecklenburg-Vorpommern"},{"DOI":"10.13039\/501100005035","name":"Biotronik","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100005035","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur J Med Res"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n<jats:title>Background<\/jats:title>\n<jats:p>Detection of atrial fibrillation (AF) after cryptogenic stroke (CS) has therapeutic implications, but the most effective type and optimal duration of monitoring have still to be defined. This study that involved patients with CS or transient ischemic attack (TIA), all of whom carried an implantable cardiac monitor (ICM), sought to assess the incidence of AF and other arrhythmia detected using tele-monitoring or interval-based follow-up by an internal cardiologist at the university medical center of Rostock (UMR) or an external cardiologist.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>The ICM implantation was performed during the inpatient stay in the neurology department, with inclusion and exclusion criteria jointly determined by the neurology and cardiology departments. Cardiologists programmed individual threshold values during ICM implantation, which were designed to instantly trigger an episode being recording and an alarm message being sent out. Outpatient care consisted of tele-monitoring of implants or interval-based follow-up care.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>The indication for ICM implantation was made for 102 patients, 88 of whom underwent ICM implantation, with full documentation available for these 88 study patients. Within a median observation period of 21.5\u00a0months, AF occurred in 19 patients, with a median observation time to the event of 7\u00a0months. In all cases, AF detection was followed by immediate medical intervention. Comparing patients with and without AF revealed that the median age of the AF group exceeded by 10\u00a0years that of the other patients. Stroke recurrence was recorded in five patients, with a median observation time to the event of 9\u00a0months. Comparing patients with and without stroke recurrence revealed that the median age in the stroke recurrence group tended to be higher by 14\u00a0years. No statistically significant between-group differences were found with regard to integration into tele-monitoring, nor were there any differences identified between outpatient care at the UMR or in the outpatient sector.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>This study confirmed the feasibility of using an interdisciplinary and intersectoral therapeutic approach for monitoring CS patients with implanted ICMs. Further randomized studies are warranted to confirm these encouraging data. An open discussion concerning optimal care forms and opportunities for introducing digitizing care pathways appears warranted.<\/jats:p>\n<\/jats:sec>","DOI":"10.1186\/s40001-020-00424-3","type":"journal-article","created":{"date-parts":[[2020,6,29]],"date-time":"2020-06-29T17:02:57Z","timestamp":1593450177000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Detection of arrhythmia using an implantable cardiac monitor following a cryptogenic stroke: a single-center observational study"],"prefix":"10.1186","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6116-7021","authenticated-orcid":false,"given":"Alper","family":"\u00d6ner","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Lips","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Uwe","family":"Walter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Storch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H\u00fcseyin","family":"Ince","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evren","family":"Caglayan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seyrani","family":"Y\u00fccel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jasmin","family":"Ortak","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Schmidt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,6,29]]},"reference":[{"key":"424_CR1","doi-asserted-by":"publisher","first-page":"141","DOI":"10.1007\/s10840-019-00628-6","volume":"57","author":"NS Milstein","year":"2020","unstructured":"Milstein NS, Musat DL, Allred J, Seiler A, Pimienta J, Oliveros S, et al. Detection of atrial fibrillation using an implantable loop recorder following cryptogenic stroke: implications for post-stroke electrocardiographic monitoring. J Interv Card Electrophysiol. 2020;57:141\u20137.","journal-title":"J Interv Card Electrophysiol"},{"key":"424_CR2","doi-asserted-by":"publisher","first-page":"120","DOI":"10.1056\/NEJMoa1105575","volume":"366","author":"J Healy","year":"2012","unstructured":"Healy J, Connolly SJ, Gold MR, Israel CW, Van Gelder IC, Capucci A, Lau CP, Fain E, Yang S, Bailleul C, Morillo CA, Carlson M, Themeles E, Kaufman ES, Hohnloser SH, ASSERT Investigators. Subclinical atrial fibrillation and the risk of stroke. N Engl J Med. 2012;366:120\u20139.","journal-title":"N Engl J Med"},{"key":"424_CR3","doi-asserted-by":"publisher","first-page":"1309","DOI":"10.1016\/j.amjcard.2012.06.034","volume":"110","author":"P Ziegler","year":"2012","unstructured":"Ziegler P, Glotzer TV, Daoud EG, Singer DE, Ezekowitz MD, Hoyt RH, Koehler JL, Coles J Jr, Wyse DG. Detection of previously undiagnosed atrial fibrillation in patients with stroke risk factors and usefulness of continuous monitoring in primary stroke prevention. Am J Cardiol. 2012;110:1309\u201314.","journal-title":"Am J Cardiol"},{"key":"424_CR4","doi-asserted-by":"publisher","first-page":"2478","DOI":"10.1056\/NEJMoa1313600","volume":"370","author":"T Sanna","year":"2014","unstructured":"Sanna T, Diener H-C, Passman RS, Di Lazzaro V, Bernstein RA, Morillo CA, et al. Cryptogenic stroke and underlying atrial fibrillation. N Engl J Med. 2014;370:2478\u201386.","journal-title":"N Engl J Med"},{"key":"424_CR5","doi-asserted-by":"publisher","first-page":"2467","DOI":"10.1056\/NEJMoa1311376","volume":"370","author":"DJ Gladstone","year":"2014","unstructured":"Gladstone DJ, Spring M, Dorian P, Panzov V, Thorpe KE, Hall J, et al. Atrial fibrillation in patients with cryptogenic stroke [EMBRACE]. N Engl J Med. 2014;370:2467\u201377.","journal-title":"N Engl J Med"},{"key":"424_CR6","doi-asserted-by":"publisher","first-page":"1261","DOI":"10.1177\/2047487316632628","volume":"23","author":"J Burkowitz","year":"2016","unstructured":"Burkowitz J, Merzenich C, Grassme K, Br\u00fcggenj\u00fcrgen B. Insertable cardiac monitors in the diagnosis of syncope and the detection of atrial fibrillation: a systematic review and meta-analysis. Eur J Prev Cardiol. 2016;23:1261\u201372.","journal-title":"Eur J Prev Cardiol"},{"key":"424_CR7","first-page":"50","volume":"70","author":"P Kirchhof","year":"2017","unstructured":"Kirchhof P, Benussi S, Kotecha D, Ahlsson A, Atar D, Casadei B, et al. 2016 ESC Guidelines for the Management of Atrial Fibrillation Developed in Collaboration With EACTS. Rev Esp Cardiol. 2017;70:50.","journal-title":"Rev Esp Cardiol"},{"key":"424_CR8","doi-asserted-by":"publisher","first-page":"1449","DOI":"10.1161\/STROKEAHA.111.676189","volume":"44","author":"M Ritter","year":"2013","unstructured":"Ritter M, Kochh\u00e4user S, Duning T, et al. Occult atrial fibrillation in cryptogenic stroke: detection by 7-day electrocardiogram versus implantable cardiac monitors. Stroke. 2013;44:1449\u201352.","journal-title":"Stroke"},{"key":"424_CR9","doi-asserted-by":"publisher","first-page":"889","DOI":"10.1016\/j.amjcard.2015.06.012","volume":"116","author":"W Choe","year":"2015","unstructured":"Choe W, Passman RS, Brachmann J, et al. A comparison of atrial fibrillation monitoring strategies after cryptogenic stroke (From the Cryptogenic Stroke and Underlying AF Trial). Am J Cardiol. 2015;116:889\u201393.","journal-title":"Am J Cardiol"},{"key":"424_CR10","doi-asserted-by":"publisher","first-page":"175","DOI":"10.1016\/j.ijcard.2017.06.039","volume":"244","author":"PD Ziegler","year":"2017","unstructured":"Ziegler PD, Rogers JD, Ferreira SW, et al. Long-term detection of atrial fibrillation with insertable cardiac monitors in a real-world cryptogenic stroke population. Int J Cardiol. 2017;244:175\u20139.","journal-title":"Int J Cardiol"},{"key":"424_CR11","doi-asserted-by":"publisher","first-page":"884","DOI":"10.1111\/ene.12400","volume":"21","author":"LM Christensen","year":"2014","unstructured":"Christensen LM, Krieger DW, H\u00f8jberg S, et al. Paroxysmal atrial fibrillation occurs often in cryptogenic ischaemic stroke final results from the SURPRISE Study. Eur J Neurol. 2014;21:884\u20139.","journal-title":"Eur J Neurol"},{"key":"424_CR12","doi-asserted-by":"publisher","first-page":"1075","DOI":"10.1093\/eurheartj\/ehz834","volume":"41","author":"NR Jones","year":"2020","unstructured":"Jones NR, Taylor CJ, Hobbs FDR, et al. Screening for atrial fibrillation: a call for evidence. Eur Heart J. 2020;41:1075\u201385.","journal-title":"Eur Heart J"},{"key":"424_CR13","unstructured":"B\u00f6tsch et al.: Telemedizinisches Nachsorgekonzept f\u00fcr Synkopen und kryptogene Schlaganf\u00e4lle durch Detektion von Arrhythmien mit einem implantierbaren Event\/Ereignisrekorder: Erfahrungen und Ergebnisse; Clin Res Cardiol 107, Suppl 3, October 2018."}],"container-title":["European Journal of Medical Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s40001-020-00424-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s40001-020-00424-3\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s40001-020-00424-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,6,28]],"date-time":"2021-06-28T23:18:56Z","timestamp":1624922336000},"score":1,"resource":{"primary":{"URL":"https:\/\/eurjmedres.biomedcentral.com\/articles\/10.1186\/s40001-020-00424-3"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,6,29]]},"references-count":13,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2020,12]]}},"alternative-id":["424"],"URL":"https:\/\/doi.org\/10.1186\/s40001-020-00424-3","relation":{},"ISSN":["2047-783X"],"issn-type":[{"value":"2047-783X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,6,29]]},"assertion":[{"value":"15 June 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"22 June 2020","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"29 June 2020","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"This study was approved by the Ethical Committee of University Hospital Rostock, and the written informed consent was collected from each participant.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"25"}}