Incidence of Silent Atrial Fibrillation in Patients With Clinically Silent Brain Ischemic Lesions
Trial Parameters
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Brief Summary
Arterial Fibrillation (AF) is well-recognized as a cause for cryptogenic Acute Ischemic Stroke (AIS) and is associated with Silent Brain Infarction (SBI). However, the role of AF in the formation of lesions (SBIs) is less well established than its role in AIS and needs clarification. The investigators hypothesize that continuous rhythm monitoring will yield a similar incidence of AF diagnosis in patients with SBI as compared to patients with cryptogenic AIS. The primary objective is to assess the cumulative incidence of AF diagnosis at 24 months in patients with SBI.
Eligibility Criteria
Inclusion Criteria: * Age * ≥ 65 years * ≥ 50 years AND one the following: * NT-proBNP \>400 pg/mL * Left atrial ventricular index \>42 ml/m2 or left atrial diameter \>46 mm * Covert infarctions with cortical involvement in more than one vascular territory (left carotid territory, right carotid territory, vertebrobasilar territory) * Written informed Consent * Any clinically silent ischemic lesions of the brain parenchyma detected on neuroimaging defined according to established criteria as either: * Diffusion weighted imaging (DWI) positive lesions: Focus of restricted diffusion (high DWI signal and low apparent diffusion coefficient value) occurring in either white or gray matter, located in the cerebrum, cerebellum, or brain stem AND not satisfying the diagnostic criteria for multiple sclerosis OR * Cavitatory Lesions: ≥ 3 mm in size that follow cerebro-spinal fluid on all sequences that are slit or wedge shaped with an irregular margin AND NOT longitudinally aligned with perforatin