[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"health-studies-list:{\"conditionNormalized\":\"embolic-stroke-of-undetermined-source\",\"overallStatus\":[\"RECRUITING\",\"AVAILABLE\",\"NOT_YET_RECRUITING\"],\"orderBy\":\"LastUpdateSubmitDate:desc\",\"size\":25,\"offset\":0}":3,"health-study-condition:embolic-stroke-of-undetermined-source":28},{"pageToken":4,"total":5,"offset":6,"count":5,"results":7},null,9,0,[8,51,86,110,141,173,202,227,256],{"id":9,"slug":10,"hasResults":11,"nctId":12,"briefTitle":13,"officialTitle":14,"acronym":15,"eligibilityCriteria":16,"healthyVolunteers":11,"sex":17,"minAge":18,"maxAge":19,"enrollmentInfo":20,"targetDuration":23,"studyType":24,"phases":4,"briefSummary":25,"conditions":26,"keywords":31,"overallStatus":38,"whyStopped":4,"lastUpdateSubmitDate":39,"lastUpdatePostDateStruct":40,"startDateStruct":43,"completionDateStruct":45,"leadSponsor":47,"locationsCount":50},"100629782","senior-stroke-prevention-in-the-elderly-by-patent-foramen-ovale-closure-vs-anticoagulation-100629782",false,"NCT07479147","SENIOR: Stroke Prevention in the Elderly by Patent Foramen Ovale closuRe vs Anticoagulation","Patent Foramen Ovale-Related Stroke Management and Outcome: Age-dependent Risk Prediction and Atrial Cardiopathy Study (SENIOR Study)","SENIOR","Inclusion Criteria:\n\n* Patient or his\u002Fher legal representative signs a written informed consent\n* Participants who have diagnosed as PFO related stroke\n* For patient aged 18-59: patient with high risk PFO feature or RoPE score ≥ 7\n* For patient aged 60-90: patient with high risk PFO feature or RoPE score ≥ 4, must include cortical infarct\n\nExclusion Criteria:\n\n* Follow-up less than 6 months\n* Extracardiac right-to-left shunt\n* Known stroke mechanism was diagnosed","ALL","18 Years","90 Years",{"count":21,"type":22},400,"ESTIMATED","3 Years","OBSERVATIONAL","Patent foramen ovale (PFO) is an important mechanism of embolic stroke of undetermined source (ESUS). Current guidelines recommend PFO closure for high-risk PFO in patients younger than 60 years, and a recent retrospective cohort study from Taichung Veterans General Hospital has shown that closure is effective and safe in older adults; however, the optimal treatment strategy for those \\>60 years and direct head-to-head comparisons of PFO closure versus direct oral anticoagulants (DOACs) remain insufficient. Robust evidence from a multicenter study combining prospective and retrospective cohorts is warranted.\n\nThe SENIOR study is a multicenter observational cohort registry with a combined retrospective and prospective design. The prospective period is from September 15, 2025 to December 31, 2031, and the retrospective period covers January 1, 2013 to September 1, 2025; target sample sizes are 400 (prospective) and 500 (retrospective). We will enroll adults with ESUS and PFO; the prospective arm will focus on patients aged \\>60 years with PFO related stroke. Treatments will be assigned as PFO closure, standard-dose DOAC, or antiplatelet agents (if DOAC intolerance) by local principal investigator. The primary outcome is recurrent ischemic stroke or transient ischemic attack. Secondary outcomes include 6-month functional outcome, all stroke, and serial comparison of atrial cardiopathy changes. Safety endpoints include peri-procedural adverse events (including newly-onset atrial fibrillation), hemorrhagic stroke, and all caused mortality. Clinical presentation, imaging, cardiac testing, biomarker, and genetic data will be collected for stratified and multivariable analyses.",[27,28,29,30],"Ischemic Stroke","Embolic Stroke of Undetermined Source","Patent Foramen Ovale (PFO)","Elderly",[32,33,34,35,36,37],"patent foramen ovale","patent foramen ovale closure","embolic stroke of undetermined source","elderly","multi-center","anticoagulation","RECRUITING","2026-03-18",{"date":41,"type":42},"2026-03-23","ACTUAL",{"date":44,"type":42},"2025-12-16",{"date":46,"type":22},"2031-12-31",{"name":48,"class":49},"Taichung Veterans General Hospital","OTHER",3,{"id":52,"slug":53,"hasResults":11,"nctId":54,"briefTitle":55,"officialTitle":56,"acronym":57,"eligibilityCriteria":58,"healthyVolunteers":11,"sex":17,"minAge":18,"maxAge":4,"enrollmentInfo":59,"targetDuration":4,"studyType":24,"phases":4,"briefSummary":61,"conditions":62,"keywords":68,"overallStatus":38,"whyStopped":4,"lastUpdateSubmitDate":75,"lastUpdatePostDateStruct":76,"startDateStruct":78,"completionDateStruct":80,"leadSponsor":82,"locationsCount":85},"100605762","high-coverage-carotid-stenting-vs-medical-management-alone-to-prevent-embolism-from-symptomatic-non-stenotic-carotid-disease-sync-100605762","NCT07166731","High Coverage CARotid Stenting vs. Medical Management Alone to Prevent EmboliSm From symptomaTic Non-stenotic cARotid Disease (SyNC)","High Coverage CARotid Stenting vs. Medical Management Alone to Prevent EmboliSm From symptomaTic Non-stenotic cARotid Disease (SyNC) - CARESTAR","CARESTAR","Inclusion Criteria:\n\n* Patients diagnosed with acute ischemic stroke or acute retinal artery ischemia within the last two weeks related to symptomatic non-stenotic carotid disease (SyNC) and high-risk carotid plaque features\n\n  * Ipsilateral acute ischemic stroke must be determined by acute ischemic infarct on DWI or CT OR\n  * by neurological symptoms indicating ipsilateral cortical deficits consistent with ischemia in the territory of the internal carotid artery and after exclusion of a significant microangiopathy\n  * Acute retinal artery ischemia must be determined by ophthalmologic examination\n* Patients with no other identifiable cause of stroke, evaluated using standard echocardiographic examinations to exclude cardiogenic or aortogenic sources of embolism\n* Symptomatic non-stenotic carotid disease defined as one or more plaques in the ipsilateral internal carotid artery causing 10-49% luminal narrowing AND\n* Presence of high-risk plaque features which must be determined through visual inspection on CTA or MRI (Ultrasound findings alone are insufficient; features must be confirmed by CTA or MRI to meet the criteria):\n\n  * Identification of at least two of the following characteristics Plaque thickness ≥ 3mm Irregular plaque surface Ulceration \\\u003C50% plaque calcification Lipid-rich necrotic core\n  * and\u002For identification of at least one of the following characteristics Intraplaque haemorrhage\n* Presence of carotid web characterized as shelf-like\u002Flinear, smooth filling defects\n* Plaque assessment including evaluation of the presence of high-risk features by routine imaging (CTA, MRI) confirmed by an independent CoreLab\n* Signed Informed Consent Form\n* Patient ≥ 18 years\n* mRS ≤ 3 at time of randomisation\n* Dual antiplatelet therapy (DAPT) according to standard of care before endovascular treatment\n\nExclusion Criteria:\n\n* Patients with acute complete occlusion of the carotid artery in an emergency setting\n* Incidence of acute infarcts in other vascular (i.e., not ipsilateral carotid) territories\n* Patients in whom the stroke was likely caused by one of the following diseases:\n* Small vessel disease\n\n  * Large vessel atherosclerotic disease ≥ 50%\n  * Cardioembolism\n  * Other known disease e.g. vasculitis\n* Predominantly calcified Plaques (≥50% calcified plaque components on CT-Angio)\n* Patients presenting with intraluminal carotid thrombus (e.g. characterized by 'donut sign' on CTA)\n* Patients with highly tortuous vessels (\\>90°) which may prevent access or safe insertion of the stent\n* Patients with post-CEA re-stenosis or post-CAS re-stenosis\n* Patients with blood coagulation disorders\n* Patients in whom access to the carotid lesion is impossible or associated with an increased risk of procedural complications\n* Patients with lesions in the ostium of the common carotid artery\n* Patients with known hypersensitivity to nickel-titanium\n* Patients who are allergic to heparin\n* Any known conditions that affect life expectancy to less than 12 months\n* Any known conditions associated with an increased risk of endovascular treatment\n* Patients not able to visit the outpatient clinic for annual follow-up",{"count":60,"type":22},536,"Goal is to analyse the clinical safety and efficacy of the CARESTO® heal Stent within standard clinical routine for the treatment of patients with symptomatic non-stenotic carotid disease (SyNC) and with high-risk plaque features for stroke recurrence compared to medical treatment alone with respect to the mid- and long-term clinical outcomes.",[63,64,65,66,28,67],"Carotid Artery Disease","Symptomatic Carotid Artery Stenosis","Carotid Artery Stenting","Carotid Plaque Imaging","Carotid Artery Thrombosis",[69,70,71,72,73,74],"SyNC","Carotid artery disease","carotid artery stenting","symptomatic non-stenotic carotid artery disease","carotid artery stenosis","symptomatic carotid artery stenosis","2026-03-03",{"date":77,"type":42},"2026-03-04",{"date":79,"type":42},"2026-03-01",{"date":81,"type":22},"2032-06",{"name":83,"class":84},"Acandis GmbH","INDUSTRY",1,{"id":87,"slug":88,"hasResults":11,"nctId":89,"briefTitle":90,"officialTitle":91,"acronym":4,"eligibilityCriteria":92,"healthyVolunteers":11,"sex":17,"minAge":93,"maxAge":4,"enrollmentInfo":94,"targetDuration":4,"studyType":96,"phases":97,"briefSummary":99,"conditions":100,"keywords":4,"overallStatus":38,"whyStopped":4,"lastUpdateSubmitDate":101,"lastUpdatePostDateStruct":102,"startDateStruct":104,"completionDateStruct":106,"leadSponsor":108,"locationsCount":85},"100615681","atrial-fibrillation-detection-using-memo-patch-in-patients-with-stroke-of-unknown-cause-100615681","NCT07295769","Atrial Fibrillation Detection Using MEMO Patch in Patients With Stroke of Unknown Cause","Atrial Fibrillation Detection Using MEMO Patch in Patients With Stroke of Unknown Cause: A Single-Center, Prospective, Exploratory Trial to Validate the Efficacy and Safety of Noninvasive Long-Term Electrocardiographic Monitoring","Inclusion Criteria:\n\nParticipants may take part in this clinical study only if they meet all of the following criteria:\n\n1. Adults aged 19 years or older who voluntarily provide written informed consent to participate in the study\n2. Patients diagnosed with ESUS (Embolic Stroke of Undetermined Source)\n3. Patients who require in-hospital or out-of-hospital electrocardiographic (ECG) monitoring\n\nExclusion Criteria:\n\nParticipants who meet any of the following criteria cannot be enrolled in this clinical study:\n\n1. Individuals already diagnosed with atrial fibrillation or atrial flutter\n2. Individuals with a clearly identified cause of stroke\n3. Individuals known to have allergic reactions to adhesives or hydrogels\n4. Individuals who, in the investigator's judgment, have cognitive vulnerability that makes it difficult to understand the study information and voluntarily decide on participation\n5. Any other individuals whom the principal investigator considers to be at potential risk by participating in the study or otherwise unsuitable for participation","19 Years",{"count":95,"type":22},100,"INTERVENTIONAL",[98],"NA","The purpose of this study is to evaluate the efficacy and safety of a wearable device in detecting previously undiagnosed atrial fibrillation through non-invasive long-term monitoring using a wearable single-lead ECG patch (MEMO Patch M, MEMO Patch2) in 100 patients with Embolic Stroke of Undetermined Source (ESUS) who require atrial fibrillation screening. Participants who meet all inclusion and exclusion criteria and provide written informed consent will wear the MEMO Patch M and undergo in-hospital telemetry monitoring using MEMO Cue for a minimum of 12 hours and up to 8 days. During hospitalization, 24-hour Holter monitoring will also be conducted. Before discharge, the investigator will review these results to determine whether implantable loop recorder (ILR) implantation is necessary. At the time of discharge, participants will wear MEMO Patch2 for up to 14 days for the first ECG monitoring period. One month after discharge, the investigator will review the results of the first monitoring and initiate the second ECG monitoring with MEMO Patch2. Three months after discharge, the results of the second ECG monitoring will be reviewed, and participation in the clinical trial will be completed.",[28],"2026-02-04",{"date":103,"type":42},"2026-02-06",{"date":105,"type":42},"2026-01-28",{"date":107,"type":22},"2029-02-15",{"name":109,"class":49},"Asan Medical Center",{"id":111,"slug":112,"hasResults":11,"nctId":113,"briefTitle":114,"officialTitle":115,"acronym":116,"eligibilityCriteria":117,"healthyVolunteers":11,"sex":17,"minAge":118,"maxAge":4,"enrollmentInfo":119,"targetDuration":121,"studyType":24,"phases":4,"briefSummary":122,"conditions":123,"keywords":124,"overallStatus":38,"whyStopped":4,"lastUpdateSubmitDate":131,"lastUpdatePostDateStruct":132,"startDateStruct":134,"completionDateStruct":136,"leadSponsor":138,"locationsCount":140},"100619674","ai-based-prediction-of-atrial-fibrillation-in-esus-patients-with-icm-100619674","NCT07347691","AI-Based Prediction of Atrial Fibrillation in ESUS Patients With ICM","Predicting Atrial Fibrillation in Patients With Post-implantable Cardiac Monitor Implementation : A Prospective, Long-term Follow-up Study Using Comprehensive AI ECG Analysis : Multicenter Prospective Study","SMART-ESUS","Inclusion Criteria:\n\n* Patients aged 30 years or older.\n* Patients diagnosed with Embolic Stroke of Undetermined Source (ESUS) who have undergone or are scheduled for Implantable Cardiac Monitor (ICM) implantation.\n* Patients who have undergone at least one 12-lead ECG examination within 2 weeks before or after the date of ICM implantation.\n* Patients maintaining Sinus Rhythm on ECG at the time of enrollment.\n* Patients who have voluntarily signed the informed consent form.\n\nExclusion Criteria:\n\n* Patients diagnosed with Atrial Fibrillation (AF) at least once prior to the date of enrollment.\n* Patients whose ICM battery status is at Elective Replacement Interval (ERI), making recording impossible.\n* Patients whose ECGs cannot be analyzed by the AI algorithm (SmartECG-AF) due to severe artifacts or noise, or are incompatible with digital analysis.","30 Years",{"count":120,"type":22},92,"12 Months","This study investigates patients with Embolic Stroke of Undetermined Source (ESUS) who have received an Implantable Cardiac Monitor (ICM). The main purpose is to evaluate the predictive value of an Artificial Intelligence ECG analysis tool, named SmartECG-AF.\n\nParticipants will be classified into two groups based on the AI analysis: a \"High Risk\" group and a \"Low to Intermediate Risk\" (control) group. The study aims to compare the incidence rate of atrial fibrillation (AF) events over time between these two groups. Additionally, the study will analyze the relationship between the AI-predicted risk levels and the occurrence of major cardiovascular events during the follow-up period.",[28],[125,126,127,128,129,130],"Implantable Cardiac Monitor","Artificial Intelligence","Deep Learning","Electrocardiography","Risk Prediction","Cryptogenic Stroke","2026-01-09",{"date":133,"type":42},"2026-01-16",{"date":135,"type":42},"2025-11-19",{"date":137,"type":22},"2028-05",{"name":139,"class":49},"Inha University Hospital",5,{"id":142,"slug":143,"hasResults":11,"nctId":144,"briefTitle":145,"officialTitle":146,"acronym":147,"eligibilityCriteria":148,"healthyVolunteers":11,"sex":17,"minAge":18,"maxAge":4,"enrollmentInfo":149,"targetDuration":4,"studyType":24,"phases":4,"briefSummary":151,"conditions":152,"keywords":157,"overallStatus":38,"whyStopped":4,"lastUpdateSubmitDate":164,"lastUpdatePostDateStruct":165,"startDateStruct":167,"completionDateStruct":169,"leadSponsor":171,"locationsCount":85},"100610176","left-atrial-strain-and-cryptogenic-stroke-100610176","NCT07224178","Left Atrial Strain and Cryptogenic Stroke","Left Atrial Strain: A Biomarker for Cryptogenic Stroke Prevention","LAS-ESUS","Inclusion Criteria:\n\n* Adult patients (age \\> 18 years and \\\u003C 80 years) who had a complete transthoracic echocardiography (TTE) exam at the University of Pittsburgh Medical Center (UPMC) Presbyterian Echocardiography Lab with a referral diagnosis of suspected stroke.\n\n  2- Patients with an established diagnosis of stroke by stroke neurologists.\n\n  3- Patients in sinus rhythm documented at the time of referral.\n\n  4- Availability of adequate echocardiographic images for strain quantification.\n\n  5- Clinical follow-up data available for evaluation of study endpoints, including stroke recurrence, atrial fibrillation development, and mortality.\n\n  6- Patients from collaborating centers will be included with de-identified echocardiographic images and clinical data meeting the above criteria.\n\nExclusion Criteria:\n\nIncomplete or technically difficult transthoracic echocardiography (TTE) studies and studies from subjects younger than 18 years of age will be excluded. Additional exclusion criteria include:\n\n1- Pre-existing atrial fibrillation (AF): Patients with a documented history AF prior to the index echocardiography study will be excluded because it is well established that AF justifies cryptogenic stroke requiring anticoagulation.\n\n2 -Structural heart disease: Patients with significant structural abnormalities, such as moderate or severe mitral stenosis, moderate or severe mitral regurgitation, prosthetic heart valves, devices in the left atrium, atrial septal defect or patent foramen ovale will be excluded as these conditions are known causes of stroke and abnormal left atrial function.\n\n3- Coagulopathy: Patient having disease leading to hypercoagulable (thrombus formation) state will be excluded (presence of cancer, antiphospholipid antibodies, hematological diseases).\n\n4- Inadequate clinical follow-up: Patients with insufficient follow-up data or missing medical records that preclude evaluation of study endpoints (e.g., stroke recurrence, AF development) will be excluded unless death is documented.\n\n5- Poor image quality for strain analysis: Patients having echo exams with inadequate image quality that prevent reliable strain quantification will be excluded.\n\n\\-",{"count":150,"type":22},900,"Cryptogenic stroke is a type of stroke in which the cause of the blood clot cannot be identified, leaving many patients without a clear treatment plan and at high risk for another stroke. Current medical guidelines recommend blood-thinning medication (anticoagulation) only when atrial fibrillation (AF) -an irregular heart rhythm- can be documented. However, AF may occur silently and remain undetected. Long term implantable (placed invasively under the skin) devices may be needed to capture these episodes.\n\nAF is known to develop from disease of the left atrium, the upper chamber of the heart that receives blood from the lungs. When the left atrium does not contract normally, blood flow may slow down, increasing the risk of clot formation. Nowadays, the left atrial (LA) function can be quantified precisely using a noninvasive ultrasound technique called strain imaging.\n\nThis study aims to determine whether reduced LA function is associated with cryptogenic stroke and its recurrence even when AF is not observed. If such an association is confirmed, LA strain could serve as a new biomarker to identify patients at risk, earlier than the development of overt AF, enhance preventive measures to reduce recurrent strokes. Because echocardiographic strain imaging is safe, cost-effective, and widely available, it may become an important tool for improving care in this high-risk population.",[153,154,155,28,156],"Ischemic Stroke, Cryptogenic","Ischemic Stroke, Embolic","Hemorrhagic Stroke","Recurrent Ischemic Stroke",[158,34,159,160,161,162,163],"stroke","speckle-tracking echocardiography","left atrial cardiomyopathy","left atrial strain","recurrent ischemic stroke","new-onset atrial fibrillation","2026-01-06",{"date":166,"type":42},"2026-01-07",{"date":168,"type":42},"2025-12-17",{"date":170,"type":22},"2027-12-31",{"name":172,"class":49},"University of Pittsburgh",{"id":174,"slug":175,"hasResults":11,"nctId":176,"briefTitle":177,"officialTitle":177,"acronym":178,"eligibilityCriteria":179,"healthyVolunteers":11,"sex":17,"minAge":18,"maxAge":4,"enrollmentInfo":180,"targetDuration":4,"studyType":24,"phases":4,"briefSummary":182,"conditions":183,"keywords":188,"overallStatus":38,"whyStopped":4,"lastUpdateSubmitDate":193,"lastUpdatePostDateStruct":194,"startDateStruct":196,"completionDateStruct":198,"leadSponsor":200,"locationsCount":50},"100523823","discovery-of-new-cancer-in-the-1-year-follow-up-after-ischemic-stroke-in-patients-at-risk-the-invisible-1-study-100523823","NCT06100718","Discovery of New Cancer in the 1-year Follow-up After Ischemic Stroke in Patients at Risk: The INVISIBLE-1 Study","INVISIBLE-1","Inclusion Criteria:\n\n* Informed consent as documented by signature from patient or next of kin\n* Age ≥ 18 years old\n* Acute ischemic stroke with symptom onset within 48 h before admission\n* Acute ischemic stroke with:\n\n  * persistent signs and symptoms of stroke lasting for ≥ 24 hours OR\n  * acute brain infarction documented by computer tomography (CT) or MRI\n* D-dimer ≥ 820 μg\u002FL measured after symptom-onset and within 24h after admission\n* Embolic stroke of unknown source (ESUS)\\* after initial work-up (acute cerebral imaging, 12-lead electrocardiogram, cardiac monitoring for at least 24h and echocardiography)\n\nExclusion Criteria:\n\n* Active cancer\\*\\* known at time of index-stroke\n* Intravenous Thrombolysis administrated prior to D-dimer measurement: Use of external laboratory value possible if available\n* New diagnosis of central nervous system cancer\n* Patient or next of kin (in case of lacking capacity) unlikely to be compliant or available for study follow-up interview\n\nESUS\\*: According to the definition from the NAVIGATE ESUS randomized trial: Non-lacunar ischemic stroke occurring in a patient in whom investigations did not show another specifically treatable underlying stroke etiology, primarily \\>50% stenosis in a proximal extracranial or intracranial artery, atrial fibrillation, other major-risk cardioembolic sources, or other determined etiology.\n\nActive Cancer\\*\\*: According to the definition from the International Society on Thrombosis and Haemostasis: Cancer diagnosed within the previous six months, recurrent, regionally advanced or metastatic cancer, cancer for which treatment had been administered within six months, or hematological malignancy that is not in complete remission for more than 5 years.\n\n► Patients with history of cancer not meeting these criteria anymore can be included in the study.",{"count":181,"type":22},370,"INVISIBLE-1 aims to prospectively follow patients up to one year after ischemic stroke to:\n\n1. Determine the cumulative incidence of occult cancer in patients with embolic stroke of undetermined source (ESUS) and elevated D-dimer\n2. Describe occult cancer characteristics and spontaneous course of occult cancer\n\nMethodology\n\nThe investigators will include 370 stroke patients with elevated D-dimer (≥ 820 μg\u002FL) at the time of stroke, suspicion of ESUS after initial workup and without known cancer. The investigators will perform a follow-up telephone interview at one year to assess the occurrence of a new cancer and characterize the course of the disease.\n\nSignificance\n\nDetermining the real incidence of occult cancer in high-risk patients will help support the implementation of screening trials in the future. Faster detection and treatment of occult cancers would significantly impact patient' outcomes by offering faster cancer treatment and optimal secondary stroke prevention.",[184,185,186,27,28,187],"Cancer-related Stroke","Paraneoplastic Coagulopathy","Occult Cancer","D-dimer",[189,187,190,191,192],"Cancer-related stroke","ESUS","Occult cancer","Ischemic stroke","2024-12-09",{"date":195,"type":42},"2024-12-13",{"date":197,"type":42},"2022-01-01",{"date":199,"type":22},"2025-12-31",{"name":201,"class":49},"Insel Gruppe AG, University Hospital Bern",{"id":203,"slug":204,"hasResults":11,"nctId":205,"briefTitle":206,"officialTitle":206,"acronym":207,"eligibilityCriteria":208,"healthyVolunteers":11,"sex":17,"minAge":18,"maxAge":4,"enrollmentInfo":209,"targetDuration":4,"studyType":96,"phases":210,"briefSummary":213,"conditions":214,"keywords":216,"overallStatus":38,"whyStopped":4,"lastUpdateSubmitDate":218,"lastUpdatePostDateStruct":219,"startDateStruct":221,"completionDateStruct":223,"leadSponsor":225,"locationsCount":85},"100571069","phase-2-empa-esus-a-randomised-control-trial-to-investigate-the-impact-of-empagliflozin-on-left-atrial-function-in-patients-with-embolic-stroke-of-undetermined-source-100571069","NCT06715449","EMPA-ESUS. a Randomised Control Trial to Investigate the Impact of Empagliflozin on Left Atrial Function in Patients with Embolic Stroke of Undetermined Source","EMPA-ESUS","Inclusion Criteria:\n\n* Age over 18 years\n* Patient has had an embolic stroke of undetermined source, defined as:\n\n  * Ischaemic stroke or transient ischaemic attack diagnosed clinically + supporting radiological features on CT or MRI imaging\n  * No clinically significant extracranial or intracranial atherosclerosis found on neck imaging\n  * No evidence of prevalent cardioembolic source of embolism - atrial dysrhythmia, cardiac thrombus, prosthetic valve, cardiac tumours, mitral stenosis, recent MI, LVEF\\\u003C35%, valvular vegetations, or infective endocarditis\n\nAND\n\n* No other specific stroke aetiology identified (pro-thrombotic states, arteritis, dissection, drug abuse)\n* Patient has been referred for an implantable loop recorder implant to investigate possible atrial dysrhythmia\n* Ability to give written, informed consent\n\nExclusion Criteria:\n\n* Prevalent atrial fibrillation or atrial flutter\n* Subsequent demonstration of a cardio-emoblic source\n* Pre-existent indication for SGLT2i including heart failure with a reduced ejection fraction and Type 1 or Type 2 diabetes mellitus\n* Contraindication to the commencement of SGLT2i including a history of, or risk factors for diabetic ketoacidosis, such as restricted food intake or a history of alcohol abuse\n* Hypersensitivity to the active substance or to any of the excipients of empagliflozin\n* Presence of alternate implantable cardiac devices such as a pacemaker or defibrillator, that would make ILR utilisation redundant\n* Any condition that may confound the results or interfere with participation such as dementia\n* An unwillingness to participate",{"count":95,"type":22},[211,212],"PHASE2","PHASE3","Atrial fibrillation (AF) is the most common heart rhythm problem in the adult population. There is a five-fold increase in stroke risk in patients with AF. Whilst there has been considerable advances in AF management including improvement in ablation therapy, preventing AF remains an unmet need.\n\nOne promising avenue is a group of medications called Sodium Glucose Cotransporter 2 (SGLT2) inhibitors, which has been studied in people with diabetes, kidney disease and weak heart muscle. These medicines were consistently found to lower the risk of developing AF. This can be promising for patients who have suffered a stroke for unclear reasons, where a significant proportion are subsequently found to have short periods of AF. Often prior to AF development, patients may have changes in the structure or function of the top chambers of their heart (the atria). This may provide a useful marker for us to understand whether SGLT2i impacts AF risk.\n\nAim of research study:\n\nThe aim of this study is to investigate whether the use of the drug empagliflozin, an SGLT2 inhibitor, prevents changes in the left atrium associated with future AF development. Using advanced imaging techniques and continuous rhyth monitoring we intend to study the effect of SGLT2 inhibitors on left atrial function and arrhythmia occurence.\n\nStudy design:\n\nPatients who are undergoing an implantable loop recorder insertion, to detect AF following a stroke, will be invited for participation. Eligible consenting patients will have a baseline assessment with echocardiography, electrocardiogram and anthropometric measures. They will then be randomised to receive either the SGLT2i alongside usual stroke care for 6 months, or usual stroke care alone. All patients will be monitored remotely via their loop recorder, and will undergo repeat electrocardiogpahic, echocardiographic and anthropometric assessment at 6 months. This way, we aim to investigate whether the SGLT2 inhibitor causes changes in atrial parameters that may be associated with future AF development.",[28,215],"Atrial Fibrillation New Onset",[217],"Atrial strain","2024-11-28",{"date":220,"type":42},"2024-12-04",{"date":222,"type":42},"2024-11-22",{"date":224,"type":22},"2029-03",{"name":226,"class":49},"University of East Anglia",{"id":228,"slug":229,"hasResults":11,"nctId":230,"briefTitle":231,"officialTitle":232,"acronym":233,"eligibilityCriteria":234,"healthyVolunteers":11,"sex":17,"minAge":18,"maxAge":4,"enrollmentInfo":235,"targetDuration":4,"studyType":24,"phases":4,"briefSummary":237,"conditions":238,"keywords":242,"overallStatus":38,"whyStopped":4,"lastUpdateSubmitDate":247,"lastUpdatePostDateStruct":248,"startDateStruct":250,"completionDateStruct":252,"leadSponsor":254,"locationsCount":85},"100442655","echocardiographic-predictors-of-atrial-fibrillation-100442655","NCT05044208","Echocardiographic Predictors of Atrial Fibrillation","Echocardiographic Predictors of Atrial Fibrillation in Patients With ESUS or TIA - Detected With 7-day ECG Monitor","EPAF-7","Inclusion Criteria:\n\nAge ≥ 18 years, written informed consent to participate in the study Clinical diagnosis of ischemic stroke or transient ischemic attack + brain imaging to rule out hemorrhagic stroke.\n\n1. Stroke: ESUS, defined as all of the following:\n\n   * Stroke detected by CT (computertomography) or MRI (magnetic resonance imaging) that is not lacunar. (Lacunar is defined as a subcortical (this includes pons and midbrain) infarct in the distribution of the small, penetrating cerebral arteries whose largest dimension is ≤1.5 cm on CT or ≤2.0 cm on MRI diffusion images\u002F\\\u003C1.5 cm on T2 weighted MR images. The following are not considered lacunes: multiple simultaneous small deep infarcts, lateral medullary infarcts, and cerebellar infarcts.)\n   * Absence of extracranial or intracranial atherosclerosis causing ≥50 percent luminal stenosis of the artery supplying the area of ischemia. Patients must undergo vascular imaging of the extracranial and intracranial vessels using either catheter angiography, CT angiogram (CTA), MR angiogram (MRA), or ultrasound, as considered appropriate by the treating physician and local principal investigator.\n   * No major-risk cardioembolic source of embolism, including intracardiac thrombus, mechanical prosthetic cardiac valve, atrial myxoma or other cardiac tumors, mitral stenosis, myocardial infarction within the last 4 weeks, left ventricular ejection fraction \\\u003C30 percent, valvular vegetations, or infective endocarditis).\n   * No other specific cause of stroke identified, such as arteritis, dissection, migraine, vasospasm, drug abuse, or hypercoagulability. Special testing, such as toxicological screens, serological testing for syphilis, and tests for hypercoagulability, will be performed at the discretion of the treating physician and local principal investigator, if needed.\n2. TIA: Patients fulfilling all above criteria and diagnostic work-up, except the detection of ischemic lesions by CT or MRI is optional and clinical symptoms last \\\u003C 1 hours.\n\nAll patients must undergo electrocardiogram, transthoracic or transesophageal echocardiography (TTE or TEE) and at least 24 hours of cardiac rhythm monitoring (Holter monitor or telemetry or equivalent).\n\nPatent foramen ovale is not an exclusion criterion. Planned or existing implantation of an implantable cardiac monitor or cardiac pacemaker is not an exclusion criterion.\n\nExclusion Criteria:\n\n* History of AF, AF on 12-lead ECG, or any AF of any duration during heart-rhythm monitoring prior to inclusion into the study\n* Technical problems or bad quality of the echocardiogram making it impossible to measure the main parameters for calculating the LaHAsPa-Score (sPA-TDI, LAVI)\n* Wearing time \\\u003C 1 week (combined recording time \\\u003C 168 hours) due to patient withdrawing from study, patch dissolving or technical defects\n* Life expectancy \\\u003C 1 month\n* Patients under custody or mentally not being able to give written informed consent",{"count":236,"type":22},200,"This prospective study aims to identify the diagnostic accuracy of echocardiographic predictors of atrial fibrillation in patients with ESUS (embolic stroke of undetermined source) or TIA (transient ischemic attack).",[239,240,28,241],"Atrial Fibrillation","Stroke, Ischemic","TIA, Brain",[243,244,245,246],"Echocardiography","Total Atrial Conduction Time","Left Atrial Strain","Left Atrial Volume","2023-03-07",{"date":249,"type":42},"2023-03-08",{"date":251,"type":42},"2021-01-01",{"date":253,"type":22},"2026-11",{"name":255,"class":49},"Karl Landsteiner University of Health Sciences",{"id":257,"slug":258,"hasResults":11,"nctId":259,"briefTitle":260,"officialTitle":261,"acronym":262,"eligibilityCriteria":263,"healthyVolunteers":11,"sex":17,"minAge":264,"maxAge":4,"enrollmentInfo":265,"targetDuration":267,"studyType":24,"phases":4,"briefSummary":268,"conditions":269,"keywords":270,"overallStatus":38,"whyStopped":4,"lastUpdateSubmitDate":272,"lastUpdatePostDateStruct":273,"startDateStruct":275,"completionDateStruct":277,"leadSponsor":279,"locationsCount":85},"100457593","prospective-registry-of-elderly-esus-with-pfo-100457593","NCT05238610","Prospective Registry of Elderly ESUS With PFO","Prospective Registry of Elderly Patients With ESUS to Evaluate the Role of Covert Atrial Fibrillation and Patent Foramen Ovale","COACH_ESUS","Inclusion Criteria:\n\n1. Patients older than 60 years-old\n2. Patients diagnosed as ESUS within 180 days from onset\n3. PFO found from TTE or TEE, which attributed to the ischemic stroke\n4. Patients or their legal representative agreed to participate\n\nExclusion Criteria:\n\n1. Patients with transient ischemic attack\n2. Patients with ischemic stroke at the vascular territory with significant stenosis\n3. Patients with high risk cardioembolic stroke detected from EKG, Holter monitoring or echocardiography\n4. Patients with other causes which may cause stroke (i.e. vasculitis, dissection, vasospasm, drug related or Moyamoya disease)\n5. Patients with active cancer\n6. Patients who need long term anticoagulation\n7. Patients who have side effect on antiplatelet treatment\n8. Patients with active internal bleeding\n9. Patients who refuse to participate","60 Years",{"count":266,"type":22},1200,"1 Year","Patent foramen ovale (PFO) is associated with an increased risk of stroke. PFO-closure was effective in preventing stroke in young stroke patients less than age 60 presented as an embolic stroke of undetermined source (ESUS). However, the benefit of PFO-closure in elderly ESUS patients is not clear. The investigators designed this prospective register-based observational study to verify the efficacy of PFO-closure in elderly ESUS patients with high-risk PFO, older than 60 years",[28],[271,32,33,35],"insertable loop recorder","2022-02-11",{"date":274,"type":42},"2022-02-14",{"date":276,"type":42},"2022-01-17",{"date":278,"type":22},"2027-05-31",{"name":109,"class":49}]