Approximately one-third of strokes are cryptogenic (lack an identifiable and treatable cause). Undetected atrial fibrillation (AF) is one suspected cause of cryptogenic stroke. Inability to detect suspected AF after cryptogenic stroke presents a clinical management dilemma.

Description of Technology: Cardiac implantable loop recorders (ILRs) assess arrhythmias in symptomatic and asymptomatic patients. These small, battery-operated, titanium-encased devices are implanted subcutaneously in the left parasternal region with the use of local anesthesia. ILRs are useful when electrocardiography (ECG) abnormalities are suspected but have not been confirmed on traditional ECG or Holter recordings.

Patient Population: ILRs are indicated for patients with clinical syndromes or situations at increased risk for cardiac arrhythmias, and those who experience transient symptoms such as dizziness, palpitation, syncope, and chest pain, which may suggest a cardiac arrhythmia.

Clinical Alternatives: Alternatives to ILRs for detection of AF in patients who have experienced a cryptogenic stroke include standard ECG or continuous external ECG or Holter monitor recordings, event recorders, external loop recorders, and cardiovascular telemetry devices.

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