[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"health-studies-list:{\"conditionNormalized\":\"ischemic-stroke-cryptogenic\",\"overallStatus\":[\"RECRUITING\",\"AVAILABLE\",\"NOT_YET_RECRUITING\"],\"orderBy\":\"LastUpdateSubmitDate:desc\",\"size\":25,\"offset\":0}":3,"health-study-condition:ischemic-stroke-cryptogenic":25},{"pageToken":4,"total":5,"offset":6,"count":5,"results":7},null,2,0,[8,51],{"id":9,"slug":10,"hasResults":11,"nctId":12,"briefTitle":13,"officialTitle":14,"acronym":15,"eligibilityCriteria":16,"healthyVolunteers":11,"sex":17,"minAge":18,"maxAge":4,"enrollmentInfo":19,"targetDuration":4,"studyType":22,"phases":4,"briefSummary":23,"conditions":24,"keywords":30,"overallStatus":38,"whyStopped":4,"lastUpdateSubmitDate":39,"lastUpdatePostDateStruct":40,"startDateStruct":43,"completionDateStruct":45,"leadSponsor":47,"locationsCount":50},"100610176","left-atrial-strain-and-cryptogenic-stroke-100610176",false,"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\\-","ALL","18 Years",{"count":20,"type":21},900,"ESTIMATED","OBSERVATIONAL","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.",[25,26,27,28,29],"Ischemic Stroke, Cryptogenic","Ischemic Stroke, Embolic","Hemorrhagic Stroke","Embolic Stroke of Undetermined Source","Recurrent Ischemic Stroke",[31,32,33,34,35,36,37],"stroke","embolic stroke of undetermined source","speckle-tracking echocardiography","left atrial cardiomyopathy","left atrial strain","recurrent ischemic stroke","new-onset atrial fibrillation","RECRUITING","2026-01-06",{"date":41,"type":42},"2026-01-07","ACTUAL",{"date":44,"type":42},"2025-12-17",{"date":46,"type":21},"2027-12-31",{"name":48,"class":49},"University of Pittsburgh","OTHER",1,{"id":52,"slug":53,"hasResults":11,"nctId":54,"briefTitle":55,"officialTitle":56,"acronym":57,"eligibilityCriteria":58,"healthyVolunteers":11,"sex":17,"minAge":59,"maxAge":4,"enrollmentInfo":60,"targetDuration":4,"studyType":62,"phases":63,"briefSummary":65,"conditions":66,"keywords":69,"overallStatus":38,"whyStopped":4,"lastUpdateSubmitDate":73,"lastUpdatePostDateStruct":74,"startDateStruct":76,"completionDateStruct":78,"leadSponsor":80,"locationsCount":50},"100516493","smartwatches-for-detection-of-atrial-fibrillation-afib-in-secondary-prevention-of-cryptogenic-stroke-100516493","NCT06005233","Smartwatches for Detection of Atrial Fibrillation (AFib) in Secondary Prevention of Cryptogenic Stroke","Smartwatches for Detection of Atrial Fibrillation (AFib) in Secondary Prevention of Cryptogenic Stroke - WATCH AFib A Prospective, Intraindividual-controlled, Multicenter Clinical Study","WATCH AFib","Inclusion Criteria:\n\n* Implanted Event Recorder with telemedicinal function (e.g., Biotronik BioMon 3m ProMRI HomeMon or similar)\n* Cryptogenic stroke (within the last six month) after full standard evaluation:\n\n  * Stroke detected by computed tomography (CT) or magnetic resonance imaging (MRI) that is not lacunar (lacunar is defined as a subcortical 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)\n  * Absence of extracranial or intracranial atherosclerosis causing ≥50 percent luminal stenosis of the artery supplying the area of ischemia\n  * No major-risk cardioembolic source of embolism (i.e., no permanent or paroxysmal atrial fibrillation, sustained atrial flutter, intracardiac thrombus, prosthetic cardiac valve, atrial myxoma or other cardiac tumors, high-grade mitral valve stenosis, recent (within four weeks) myocardial infarction, left ventricular ejection fraction \\\u003C30 percent, valvular vegetations, or infective endocarditis)\n  * No other specific cause of stroke identified (e.g., arteritis, dissection, migraine, vasospasm, drug abuse)\n  * No paroxysmal atrial fibrillation in 72h of in-hospital ECG-monitoring, including at least one Holter- ECG for 24 hours.\n* Cryptogenic TIA with definite cortical syndrome (aphasia, neglect or homonymous hemianopia) (within the last six month) after full standard evaluation (see above)\n* Age: ≥40 yrs.\n* At least one of the following risk factors:\n\n  * CHA2DS2VASc score ≥4\n  * Atrial runs\n  * Left atrial size \\> 45mm\n  * Left atrial appendage flow ≤ 0.2m\u002Fs\n* No contraindication for anticoagulant therapy after acute phase of stroke\n* Written informed consent by patient or authorized caregiver\n\nExclusion Criteria:\n\n* Patient is not able to perform 1-lead ECG recording with smartwatch\n* Patient possesses no smartphone (iOS version ≥10.0 or Android)\n* Implanted pacemaker or cardioverter defibrillator (ICD)\n* Pregnancy and breastfeeding period","40 Years",{"count":61,"type":21},400,"INTERVENTIONAL",[64],"NA","Scientific Background: In secondary prevention of ischemic stroke, detection of atrial fibrillation (AFib) and subsequent anticoagulation therapy reduce the risk of recurrent stroke by approximately 60%. Prolonged electrocardiogram (ECG) monitoring up to 6 months significantly increases detection of AFib in cryptogenic stroke. Wearables like smartwatches have recently been shown to adequately detect AFib in the general population. Thus, prolonged ECG monitoring after cryptogenic ischemic stroke or transient ischemic attack (TIA) using a smartwatch could lead to a reduction of recurrent stroke by prompting adequate anticoagulation therapy and may constitute a cost-effective, non-invasive, and broadly-available alternative to the current standard of care.\n\nHypothesis: The investigators hypothesize that AFib detection via smartwatch in patients with cryptogenic TIA or ischemic stroke is accurate compared to an implantable event recorder.\n\nMethods: The investigators introduce a prospective, intraindividual-controlled, multicentre clinical study in patients with cryptogenic ischemic stroke or TIA. In addition to an implanted event recorder as indicated by clinical standard, included patients receive a smartwatch for detection of AFib. ECG-data from smartwatches will be continuously monitored by two independent cardiologists. As soon as AFib is confirmed, a doctoral appointment is set to evaluate start of anticoagulation. The follow-up period will be six months. The study consists of four study visits: a baseline visit, two phone visits at one and three months, and an end of trial visit at six months.\n\nPrimary Objective: To compare smartwatch and event recorder based analysis for sensitivity and specificity of AFib detection per patient after six months",[25,67,68],"Transient Ischemic Attack","Atrial Fibrillation",[70,71,72],"Smartwatch","Ischemic stroke","atrial fibrillation","2024-12-09",{"date":75,"type":42},"2024-12-13",{"date":77,"type":42},"2024-10-15",{"date":79,"type":21},"2026-07",{"name":81,"class":49},"Technical University of Munich"]