Overview
The purpose of DEFENSE-ELDERLY is to identify the prevalence of AF and evaluate the clinical impact of AF in elderly ESUS patients and no other known sources of stroke besides a high-risk patent foramen ovale, and compare it with elderly ESUS patients without high-risk PFO (no PFO or non-high risk PFOs)
Description
The purpose of DEFENSE-ELDERLY is to identify the prevalence of AF and evaluate the clinical impact of AF in elderly ESUS patients and no other known sources of stroke besides a high-risk patent foramen ovale, and compare it with elderly ESUS patients without high-risk PFO (no PFO or non-high risk PFOs)
Eligibility
Inclusion Criteria:
- Patients ≥60 y/o with ESUS and PFO that is likely to have causative role (high-risk anatomical feature) (cohort A)
- Patients ≥60 y/o with ESUS without PFO, or with non-high risk PFO (cohort B)
- The patient or guardian agrees to the study protocol and the schedule of clinical follow-up, and provides informed, written consent, as approved by the institutional review board
- Patients who are scheduled to have implantable cardiac monitoring
Exclusion Criteria:
- Transient ischemic attack
- Lacunar infarction (infarction at subcortical area with a lesion diameter less than 2cm on MR)
- Presence of complex aortic atheroma (≥4mm in plaque thickness or presence of mobile components)
- Presence of ≥50% luminal stenosis (extra- or intracranial) in arteries supplying the ischemic area
- Unwillingness or inability to comply with the procedures described in this protocol
- Life expectancy < 1 years for any non-cardiac or cardiac causes