MedPath

Study of Continuous Cardiac Monitoring to Assess Atrial Fibrillation After Cryptogenic Stroke

Phase 4
Completed
Conditions
Cryptogenic Ischemic Stroke
Cryptogenic Symptomatic Transient Ischemic Attack
Interventions
Device: Reveal® XT Insertable Cardiac Monitor
Registration Number
NCT00924638
Lead Sponsor
Medtronic Cardiac Rhythm and Heart Failure
Brief Summary

The 2006 American Heart Association / American Stroke Association Council on Stroke Guidelines for Prevention of Stroke in Patients With Ischemic Stroke or Transient Ischemic recommended that patients with cryptogenic stroke take antithrombotic drugs (i.e. aspirin) in order to prevent a second stroke. When a stroke patient is found to have atrial fibrillation (AF), the guidelines recommend oral anticoagulation due to its superior efficacy over aspirin for stroke prevention. Physicians can best optimize the use of medicines only if they can precisely and correctly diagnose a patient's AF. The purpose of this study is to evaluate the time to first AF by 6 months' continuous rhythm monitoring versus control treatment in subjects with a recent cryptogenic stroke or Transient Ischemic Attack (TIA) without history of AF.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
447
Inclusion Criteria
  1. Recent cryptogenic symptomatic transient ischemic attack (TIA) or cryptogenic ischemic stroke.
Exclusion Criteria
  1. Known etiology of TIA or stroke.
  2. Untreated hyperthyroidism.
  3. Myocardial infarction less than 1 month prior to stroke or TIA.
  4. Coronary bypass grafting less than 1 month prior to stroke or TIA.
  5. Valvular disease requiring immediate surgical intervention.
  6. History of AF or atrial flutter.
  7. Patent Foramen Ovale (PFO) and PFO is or was an indication to start oral anticoagulation (OAC).
  8. Permanent indication for OAC at enrollment.
  9. Permanent contra-indication for OAC.
  10. Included in another clinical trial.
  11. Life expectancy less than 1 year.
  12. Pregnant.
  13. Indicated for Implantable Pulse Generator (IPG), Implantable Cardioverter-Defibrillator (ICD), Cardiac Resynchronization Therapy (CRT) or an implantable hemodynamic monitoring system.
  14. Not fit, unable or unwilling to follow the required procedures of the protocol.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Continuous MonitoringReveal® XT Insertable Cardiac MonitorContinuous cardiac monitoring by the Reveal® XT Insertable Cardiac Monitor
Primary Outcome Measures
NameTimeMethod
AF Detection Rate Within 6 Months6 months

Percentage of subjects with AF detected within 6 months of follow-up

Secondary Outcome Measures
NameTimeMethod
AF Detection Rate Within 12 Months12 months

Percentage of subjects with AF detected within 12 months of follow-up

Incidence of Recurrent Stroke or TIA (Transient Ischemic Attack)12 months

Percentage of subjects with recurrent stroke or TIA within 12 months of follow-up

Use of Oral Anticoagulation (OAC) Drugs12 months

Percentage of subjects who were using OAC drugs at the 12 months follow-up visit

Use of Antiarrhythmic Drugs12 months

Percentage of subjects who were using antiarrhythmic drugs at the 12 months follow-up visit

Health Outcome as Evaluated by EQ-5D Questionnaire12 months

EQ-5D VAS (visual analog scale) quality of life score, which is a continuous measure of quality of life ranging from 0 (worst) to 100 (perfect health).

Clinical Disease Burden and Care Pathway12 months

Incidence of cardiovascular (CV) or stroke/TIA related hospitalizations within 12 months

Impact of Patient Assistant Use on AF DiagnosisFollow-up closure

AF detection lag (days from AF occurrence to AF diagnosis) characterized by patient assistant (PA) use frequency

Trial Locations

Locations (55)

Baylor Research Institute

🇺🇸

Dallas, Texas, United States

Iowa Heart / Ruan Neurology

🇺🇸

Des Moines, Iowa, United States

Mid America Heart Institute / St. Lukes Hospital

🇺🇸

Kansas City, Missouri, United States

Washington University Medical School

🇺🇸

St. Louis, Missouri, United States

Forsyth Medical Center

🇺🇸

Winston-Salem, North Carolina, United States

Ohio Health Research

🇺🇸

Columbus, Ohio, United States

Central Bucks Specialists / Doylestown Hospital

🇺🇸

Doylestown, Pennsylvania, United States

Lankenau

🇺🇸

Wynnewood, Pennsylvania, United States

University of Texas - Southwestern Medical Center

🇺🇸

Dallas, Texas, United States

Landesklinikum Donauregion Tulln

🇦🇹

Tulln, Austria

CHUS / Hopital Fleurimont

🇨🇦

Sherbrooke, Quebec, Canada

Clinique Parly II - Centre Hospitalier de Versailles

🇫🇷

Le Chesnay, France

Klinikum Coburg GmbH

🇩🇪

Coburg, Bayern, Germany

Klinikum Dortmund

🇩🇪

Dortmund, Germany

Universitätsklinikum Essen

🇩🇪

Essen, Germany

Asklepios Altona

🇩🇪

Hamburg, Germany

UMG, Goettingen

🇩🇪

Goettingen, Germany

Städtisches Klinikum Karlsruhe GmbH

🇩🇪

Karlsruhe, Germany

Policlinico Universitario Agostino Gemelli

🇮🇹

Rome, Italy

Ospedale Bolognini

🇮🇹

Seriate, Italy

Atrium Medisch Centrum

🇳🇱

Heerlen, Netherlands

St. Antonius Ziekenhuis

🇳🇱

Nieuwegein, Netherlands

Hospital Puerta de Hierro Majadahonda

🇪🇸

Majadahonda, Spain

University Hospital Lund

🇸🇪

Lund, Sweden

Cardiology Associates Research, LLC

🇺🇸

Tupelo, Mississippi, United States

Northwestern Memorial Hospital

🇺🇸

Chicago, Illinois, United States

Asklepios Barmbek

🇩🇪

Hamburg, Germany

Hackensack University Medical Center

🇺🇸

Hackensack, New Jersey, United States

Greenville Hospital System Cardiology/Cardiovascular Research

🇺🇸

Greenville, South Carolina, United States

Sacred Heart Medical Center

🇺🇸

Eugene, Oregon, United States

LKH Universitätsklinikum Graz

🇦🇹

Graz, Austria

AKH Linz

🇦🇹

Linz, Austria

UZ Antwerpen

🇧🇪

Antwerp, Belgium

Brussels Heart Center (St. Lean - St. Pierre)

🇧🇪

Brussels, Belgium

UZ Leuven

🇧🇪

Leuven, Belgium

Cliniques Universitaires UCL Mont-Godinne

🇧🇪

Mont Godinne, Belgium

Hamilton Health Sciences / Hamilton General Hospital

🇨🇦

Hamilton, Ontario, Canada

Neurology clinic, Turku University Central Hospital

🇫🇮

Turku, Finland

Hôpital Saint André -CHU de Bordeaux

🇫🇷

Bordeaux, France

Hôpital de la Timone

🇫🇷

Marseille, France

Universitätsklinikum der Ernst-Moritz-Arndt-Universität Greifswald

🇩🇪

Greifswald, Germany

Henry Dunant General Hospital

🇬🇷

Athens, Greece

Ospedale Misericordia di Grosseto

🇮🇹

Grosseto, Italy

Knappschaftskrankenhaus Bochum

🇩🇪

Bochum, Germany

Kreiskrankenhaus Rastatt

🇩🇪

Rastatt, Germany

Ospedale di Imperia

🇮🇹

Imperia, Italy

UMC Utrecht

🇳🇱

Utrecht, Netherlands

NUSCH, a.s. Bratislava

🇸🇰

Bratislava, Slovakia

VUSCH Kosice

🇸🇰

Kosice, Slovakia

El Camino Hospital

🇺🇸

Mountain View, California, United States

Louisville Cardiology

🇺🇸

Louisville, Kentucky, United States

South Denver Cardiology / Swedish Medical Center

🇺🇸

Denver, Colorado, United States

Skejby Hospital

🇩🇰

Aarhus, Denmark

St. Thomas Research Institute

🇺🇸

Nashville, Tennessee, United States

Thomas Jefferson University

🇺🇸

Philadelphia, Pennsylvania, United States

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