ABSTRACT NUMBER: ESOC2026A749 EXTENDED MONITORING INSERTABLE CARDIAC HOLTER EFFICIENCY AND ANALYSIS OF THE SUITABILITY OF REFFERAL CRITERIA THROUGH AF ESUS SCORE SCALE

Abstract Background and aims Insertable cardiac holter allows extended monitoring ECG in patients with suspect of ESUS (Embolic Stroke of Undetermined Source), but they need to be implanted and are more expensive compared to extracardiac devices. Supporting tools to select patients, like AF-ESUS SCORE, could improve the resource, specially in patients with lower atrial fibrilation (AF) probability. Methods Retrospective observational study through long-term follow-up of patients with stroke reffered to Arrhythmia Unit (2019-2021) for insertable cardiac monitoring, prior to validation of AF-ESUS score. Results 81 patients were analized (9.04% of total stroke in study period). Women were 43.2%. AF detection was 32.9% without significant differences by sex. Average time to detection, 280 days (median 205). Average time to end of monitoring 1188.7 days (SD ± 386,34). In 89,9% AF-ESUS score was ≥ 1 (average score 3. SD ± 2,11). Age ≥ 60 years and left ventricular hypertrophy (LVH, negative value in AF-ESUS score) parameters, presented a significant association with AF detection in our sample. Only 6,2% of patients had recurrent stroke. Conclusions Insertable cardiac holter detects AF in an elevated percentage of ESUS, needing an extended registration period. Age and LVH were best predictors of AF in our sample. Although clinical and radiological characteristics allow to suspect embolic stroke etiology, analyzing in the future use of screening tools, we´ll know its usefulness in patients with lower risk of AF, possibly not included in our sample. Conflict of interest All of authors have nothing to disclose