AI-Based Prediction of Atrial Fibrillation in ESUS Patients With ICM

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Total Enrollment

92 participants

Study Classification

OBSERVATIONAL

Study Start Date

2025-11-19

Study Completion Date

2028-05-31

Brief Summary

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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.

Participants 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.

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Detailed Description

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Embolic Stroke of Undetermined Source (ESUS) accounts for a significant proportion of ischemic strokes, and occult Atrial Fibrillation (AF) is considered a major etiology. While Implantable Cardiac Monitors (ICMs) are the gold standard for long-term rhythm monitoring, identifying patients at the highest risk for AF remains a clinical challenge.

This multicenter, prospective study aims to validate the clinical utility of an artificial intelligence-based electrocardiogram analysis algorithm, "SmartECG-AF," in this specific population. The algorithm analyzes 12-lead ECGs recorded during sinus rhythm to detect subtle signs of electrical remodeling associated with paroxysmal AF.

Enrolled patients with ESUS who have undergone ICM implantation will have their baseline ECGs analyzed by the SmartECG-AF algorithm. Based on the AI-generated probability score, patients will be stratified into a "High Risk" group and a "Low to Intermediate Risk" group. The study will longitudinally track these patients to compare the time-to-event for ICM-detected AF between the two groups. Additionally, the study will evaluate the correlation between the AI risk score and the incidence of Major Adverse Cardiovascular Events (MACE), providing evidence for AI-guided risk stratification in cryptogenic stroke management.

Conditions

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Embolic Stroke of Undetermined Source

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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High Risk Group

Patients classified as having a high risk of atrial fibrillation by the SmartECG-AF AI algorithm.

No interventions assigned to this group

Low to Intermediate Risk Group

Patients classified as having a low to intermediate risk of atrial fibrillation by the SmartECG-AF AI algorithm.

No interventions assigned to this group

Eligibility Criteria

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Inclusion Criteria

* Patients aged 30 years or older.
* Patients diagnosed with Embolic Stroke of Undetermined Source (ESUS) who have undergone or are scheduled for Implantable Cardiac Monitor (ICM) implantation.
* Patients who have undergone at least one 12-lead ECG examination within 2 weeks before or after the date of ICM implantation.
* Patients maintaining Sinus Rhythm on ECG at the time of enrollment.
* Patients who have voluntarily signed the informed consent form.

Exclusion Criteria

* Patients diagnosed with Atrial Fibrillation (AF) at least once prior to the date of enrollment.
* Patients whose ICM battery status is at Elective Replacement Interval (ERI), making recording impossible.
* Patients whose ECGs cannot be analyzed by the AI algorithm (SmartECG-AF) due to severe artifacts or noise, or are incompatible with digital analysis.

Minimum Eligible Age

30 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No