Effect of Implantable Cardiac Monitors on Preventing Stroke: A Systematic Review and Meta-Analysis of Randomized Clinical Trials

Authors

Jialing He
Yaxin Jiang
Yangchun Xiao
Pengfei Hao
Tiangui Li
Liyuan Peng
Yuning Feng
Xin Cheng
Haidong Deng
Peng Wang
Weelic Chong, Thomas Jefferson UniversityFollow
Yang Hai, Thomas Jefferson UniversityFollow
Lvlin Chen
Chao You
Lu Jia
Fang Fang
Shui Yu
Yu Zhang

Document Type

Article

Publication Date

7-20-2023

Comments

This article is the author's final published version in PLoS ONE, Volume 18, Issue 7, 2023, Article number e0287318.

The published version is available at https://doi.org/10.1371/journal.pone.0287318. Copyright © 2023 He et al.

Abstract

BACKGROUND AND AIM: Implantable cardiac monitors (ICM) can facilitate the detection of asymptomatic atrial fibrillation episodes. We performed a systematic review and meta-analysis to investigate whether ICM can prevent stroke in patients with prior stroke and risk factors for stroke.

METHODS: This study included randomized controlled trials comparing ICM with conventional (non-ICM) external cardiac monitoring in patients with prior stroke and risk factors for stroke. We searched Medline, Embase, and CENTRAL from inception until January 5, 2022, without language restriction. Quantitative pooling of the data was undertaken using a random-effects model. The primary outcome was ischemic stroke at the longest follow-up.

RESULTS: Four trials comprising 7237 patients were included. ICM was significantly associated with decreased risk of ischemic stroke (RR 0.76; 95% CI, 0.59-0.97; moderate-quality evidence) in patients with prior stroke and risk factors for stroke. ICM was associated with higher detection of atrial fibrillation (RR 4.21, 95% CI 2.26-7.85) and use of oral anticoagulants (RR 2.29, 95% CI 2.07-2.55).

CONCLUSIONS: ICM results in a significantly lower risk of ischemic stroke than conventional (non-ICM) external cardiac monitoring in patients with prior stroke and risk factors for stroke. Due to the clinical heterogeneity of study population and limited related studies, more trials were needed to furtherly explore the topic in patients with prior stroke or high risk of stroke.

Recommended Citation

He, Jialing; Jiang, Yaxin; Xiao, Yangchun; Hao, Pengfei; Li, Tiangui; Peng, Liyuan; Feng, Yuning; Cheng, Xin; Deng, Haidong; Wang, Peng; Chong, Weelic; Hai, Yang; Chen, Lvlin; You, Chao; Jia, Lu; Fang, Fang; Yu, Shui; and Zhang, Yu, "Effect of Implantable Cardiac Monitors on Preventing Stroke: A Systematic Review and Meta-Analysis of Randomized Clinical Trials" (2023). Department of Medical Oncology Faculty Papers. Paper 243.
https://jdc.jefferson.edu/medoncfp/243

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 License.

PubMed ID

37471323

Language

English