{"id":31119,"date":"2020-04-15T05:36:00","date_gmt":"2020-04-15T00:06:00","guid":{"rendered":"https:\/\/johnsonfrancis.org\/professional\/?p=31119"},"modified":"2020-04-15T05:36:00","modified_gmt":"2020-04-15T00:06:00","slug":"af-in-cryptogenic-stroke-cardiology-mcq-answer","status":"publish","type":"post","link":"https:\/\/johnsonfrancis.org\/professional\/af-in-cryptogenic-stroke-cardiology-mcq-answer\/","title":{"rendered":"AF in cryptogenic stroke &#8211; Cardiology MCQ &#8211; Answer"},"content":{"rendered":"<p><iframe loading=\"lazy\" width=\"560\" height=\"315\" src=\"https:\/\/www.youtube.com\/embed\/ikNeXHpTCcQ\" title=\"YouTube video player\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture\" allowfullscreen=\"\"><\/iframe><\/p>\n<h2><span style=\"color: #008000;\">AF in cryptogenic stroke &#8211; Cardiology MCQ &#8211; Answer<\/span><\/h2>\n<p><strong><span style=\"color: #0000ff;\">CRYSTAL AF trial used implantable cardiac monitor to detect AF. Percentage of AF detected at 3 years &#8211; Correct answer: <\/span><span style=\"font-size: inherit; color: #0000ff;\">d) 30%<\/span><\/strong><\/p>\n<p>CRYSTAL AF (Cryptogenic Stroke and Underlying Atrial Fibrillation) trial randomized 441 patients with cryptogenic stroke with no evidence of AF on 24 hour monitoring. At six months AF was noted in 8.9% of study group vs 1.4% in the control group, which became 12.$% and 2% at 12 months, using an implantable cardiac monitor [1]. At 3 years, the detection rate was 30% with the implantable cardiac monitor while it was only 3% in the control group [2].<\/p>\n<p>This study high lights the fact that a 24 hour Holter monitoring grossly underestimates the occurrence of AF in those with cryptogenic stroke. Guidelines recommend a minimum of 72 hour ECG monitoring&nbsp; in patients with transient ischemic attack (TIA) or ischemic stroke to screen for AF [3].<\/p>\n<p><a href=\"https:\/\/johnsonfrancis.org\/professional\/af-in-cryptogenic-stroke-cardiology-mcq\/\"><strong>Back to question<\/strong><\/a><\/p>\n<p><span style=\"color: #0000ff;\"><strong>Reference<\/strong><\/span><\/p>\n<ol>\n<li>Sanna T, Diener HC, Passman RS, Di Lazzaro V, Bernstein RA, Morillo CA, Rymer MM, Thijs V, Rogers T, Beckers F, Lindborg K, Brachmann J; CRYSTAL <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/24963567\">AF Investigators. Cryptogenic stroke and underlying atrial fibrillation<\/a>. N Engl J Med. 2014 Jun 26;370(26):2478-86.<\/li>\n<li>Brachmann J, Morillo CA, Sanna T, Di Lazzaro V, Diener HC, Bernstein RA, Rymer M, Ziegler PD, Liu S, Passman RS. <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/26763225\">Uncovering Atrial Fibrillation Beyond Short-Term Monitoring in Cryptogenic Stroke Patients: Three-Year Results From the Cryptogenic Stroke and Underlying Atrial Fibrillation Trial<\/a>. Circ Arrhythm Electrophysiol. 2016 Jan;9(1):e003333.<\/li>\n<li>Kirchhof P, Benussi S, Kotecha D, Ahlsson A, Atar D, Casadei B, Castella M, Diener HC, Heidbuchel H, Hendriks J, Hindricks G, Manolis AS, Oldgren J, Popescu BA, Schotten U, Van Putte B, Vardas P; ESC Scientific Document Group. 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS. Eur Heart J. 2016 Oct 7;37(38):2893-2962.<\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"<p>AF in cryptogenic stroke &#8211; Cardiology MCQ &#8211; Answer CRYSTAL AF trial used implantable cardiac monitor to detect AF. Percentage of AF detected at 3 years &#8211; Correct answer: d) 30% CRYSTAL AF (Cryptogenic Stroke and Underlying Atrial Fibrillation) trial randomized 441 patients with cryptogenic stroke with no evidence of AF on 24 hour monitoring. [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":31005,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"nf_dc_page":"","footnotes":""},"categories":[3,5],"tags":[],"class_list":["post-31119","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-cardiology-mcq","category-dm-dnb-cardiology-entrance"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.9 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>AF in cryptogenic stroke - Cardiology MCQ - Answer - All About Cardiovascular System and Disorders<\/title>\n<meta name=\"description\" content=\"AF in cryptogenic stroke: CRYSTAL AF trial documented AF in 30% of patients at 3 years with implantable cardiac monitor. 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