Atrial Fibrillation Screening Post Ischemic Cerebrovascular Events
Sweden3,300 participantsStarted 2022-01-20
Plain-language summary
Stroke is one of the leading causes behind death and permanent disability in adults. Atrial fibrillation (AF) is the most common clinical arrhythmia and its prevalence is steeply increasing with age. Atrial fibrillation is associated with a manifold increase in the risk for stroke.
It is considered important to investigate the heart rhythm in stroke survivors without previously known AF, because detection of AF will prompt a change in antithrombotic treatment with subsequent lowering of the risk of recurrent stroke.
There are so far very few studies on the prognostic impact of ECG investigations post stroke. Despite this knowledge gap, ECG investigation post stroke is given high priority in national and international guidelines.
Considerable clinical resources are currently invested in these ECG investigations without knowledge of its utility.
The investigators plan a nationwide, randomised, register-based study (RRCT) including patients aged at least 70 years receiving in-hospital care for stroke or TIA (Transient Ischemic Attack). Included patients will be randomised to standard investigation (1-2 days of ECG ) or extended ECG investigation (14 days of ECG performed at least twice). Patients diagnosed AF will be offered anticoagulation treatment. Long-term follow-up will be performed via swedish health care registers.
The result of this trial will have major impact on the ECG screening recommendations for patients who have had stroke, a large group of patients with dismal prognosis.
Who can participate
Age range
70 Years
Sex
ALL
See this in plain English?
AI-rewrites the medical criteria so a patient or caregiver can understand them. Always confirm with the trial site.
Inclusion Criteria:
* Patients aged ≥ 70 years
* A diagnosis of ischemic stroke or TIA within 14 days from inclusion.
Exclusion Criteria:
* Previously diagnosed atrial fibrillation
* Contraindication to oral anticoagulant treatment according to Summary of Product Characteristics.
* Indication for anticoagulant treatment other than atrial fibrillation, e.g. venous thromboembolism or mechanical heart valve prosthesis
* Dual antiplatelet therapy not interchangeable to oral anticoagulation
* Patients with pacemaker, implantable cardioverter defibrillator or implantable cardiac monitor.
* Patients who, according to the investigator, will not be able to comply with the study protocol.
Questions worth asking your doctor
Bring these to your next appointment. They're a starting point for a shared conversation — not a sign you qualify or a recommendation to enrol.
1This trial is specifically for people who've already had an ischemic stroke or TIA — given my own history, is my situation a close enough match for my doctor to think this study's findings might apply to me?
2The trial is measuring a combined outcome of stroke, death, and intracerebral bleeding — can you help me understand what that means for how they're judging whether the screening approach is safe and effective, and what the current data suggests so far?
3Since this trial is listed as 'active, not recruiting,' I can't join it now — but are there similar atrial fibrillation screening studies after stroke or TIA that I could still be considered for?
4This study seems to be testing a screening strategy rather than a new drug or device — can you explain what kind of AFib monitoring they're using, and whether that same approach is something we could consider for my care outside of a trial?
5Given that AFib after a stroke or TIA can affect my risk of having another stroke, what's the current standard recommendation for monitoring me for AFib, and how does what this trial is studying compare to that standard approach?
Generated to help you prepare — always confirm anything about your own eligibility and care with the study team and your doctor.
Questions for the trial coordinator
The trial coordinator is the person who runs the study day to day. These cover the practical side — logistics, costs, and what taking part would actually mean for your life. The study team confirms whether you meet the criteria; these are questions to ask, not a sign you qualify.
1What does taking part actually involve week to week — how many visits, where, and how long does each one take?
2What costs are covered by the study, and what might I have to pay for myself, including travel, parking, or time off work?
3What happens during screening, and what happens if the study team confirms I don't meet the criteria after those tests?
4Who pays for the scans, blood work, and other tests the trial requires — the study, my insurance, or me?
5How will being in the trial affect my regular care, and will my own doctor stay informed and involved?
6Can I leave the trial at any point if I change my mind, and what would happen to my care if I do?
A starting point for the conversation — always confirm anything about your own eligibility, costs, and care with the study team and your doctor.
What they're measuring
1
Composite of stroke, death and intracerebral bleeding
Timeframe: at least 36 months of follow-up (study event driven)