ABSTRACT NUMBER: ESOC2026A1549 APPROACHES FOR THE DETECTION OF ATRIAL FIBRILLATION IN PATIENTS WITH ISCHEMIC STROKE IN FERMO STROKE UNIT: A RETROSPECTIVE SINGLE-CENTER STUDY

Abstract Background and aims Atrial fibrillation (AF) is associated with a five-fold increase in risk of stroke and is responsible for 20% of all ischemic strokes and up to 46% of embolic stroke of undetermined source (ESUS). We want to evaluate whether the AF detection methods adopted so far in our center are effective. Methods We recruited 503 patients with ischemic stroke without previous AF admitted to our Stroke Unit (SU). All patients underwent continuous cardiac monitoring for an average of 3.5 days and 24-hour Holter monitoring within 7 days: 79 presented AF, 73% during SU monitoring. Once discharged, patients requiring implantable loop recorders (ILR) must be sent to other hospitals and the average placement time is 53 days. So in the last 5 years, within 10 days of discharge, 51 patients with cryptogenic stroke placed an external continuous cardiac monitoring for 30 days (Nuubo®): 6 presented AF, 10 presented atrial high-rate episodes (AHRE) and in 12 we founded other causes of stroke. Patients with AHRE and another 10 patients, in whom ESUS remained strongly suspected, placed ILR, finding 4 AF in 3 months and 6 AF in 12 months, 8 of whom had previously AHRE. Results In conclusion we found AF in 18,8% of all ischemic strokes and in 41% of cryptogenic strokes. These are slightly lower data than those reported in the literature, but still satisfactory considering the logistical difficulties for ILR. Conclusions Identifyng covert AF remains challenging. Combining long term non-invasive and invasive monitoring plays an effective role in our management strategy. Conflict of interest ACCIARRI MARIA CRISTINA: nothing to disclose. ANGELOCOLA STEFANIA MARTINA: nothing to disclose. TIBERI RICCARDO: Novartis. BALESTRINI JURI : nothing to disclose. CARDINALI PATRIZIO: nothing to disclose.