NCT02700945

Brief Summary

The purpose of the Stroke AF study is to compare the incidence of atrial fibrillation (AF) through 12 months between continuous cardiac rhythm monitoring with the Reveal LINQ™ Insertable Cardiac Monitor (ICM) (continuous monitoring arm) and standard of care (SoC) medical treatment (control arm) in subjects with a recent ischemic stroke of presumed known origin.

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
496

participants targeted

Target at P75+ for not_applicable

Timeline
Completed

Started Mar 2016

Longer than P75 for not_applicable

Geographic Reach
1 country

35 active sites

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Start

First participant enrolled

March 1, 2016

Completed
1 day until next milestone

First Submitted

Initial submission to the registry

March 2, 2016

Completed
5 days until next milestone

First Posted

Study publicly available on registry

March 7, 2016

Completed
4.4 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

August 3, 2020

Completed
1.3 years until next milestone

Results Posted

Study results publicly available

November 9, 2021

Completed
9 months until next milestone

Study Completion

Last participant's last visit for all outcomes

July 28, 2022

Completed
Last Updated

May 26, 2023

Status Verified

April 1, 2023

Enrollment Period

4.4 years

First QC Date

March 2, 2016

Results QC Date

August 5, 2021

Last Update Submit

April 28, 2023

Conditions

Outcome Measures

Primary Outcomes (1)

  • The Rate of AF Through 12 Months in Subjects With a Recent Ischemic Stroke of Presumed Known Origin.

    AF will be defined as an AF event lasting more than 30 seconds. The first AF episode detected and adjudicated by the endpoint adjudication committee will be used for this analysis.

    12 months

Secondary Outcomes (1)

  • The Rate of AF Through the Duration of Study Follow-up (36 Months) Between Study Arms.

    3 years

Study Arms (2)

Reveal LINQ™ Insertable Cardiac Monitor

ACTIVE COMPARATOR

Subjects randomized to the Reveal LINQ™ Insertable Cardiac Monitor arm will be continuously monitored via the inserted Reveal LINQ™ device.

Device: Reveal LINQ™ Insertable Cardiac Monitor

Control Arm

NO INTERVENTION

Subjects randomized to the control arm will be followed per site specific standard of care.

Interventions

The Medtronic Reveal LINQ™ ICM is a programmable device that continuously monitors a patient's ECG (electrocardiogram) and other physiological parameters. The device records cardiac information in response to automatically detected arrhythmias and patient activation.

Also known as: LINQ, LINQ™
Reveal LINQ™ Insertable Cardiac Monitor

Eligibility Criteria

Age50 Years+
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Subject has had an ischemic stroke believed to be due to small vessel disease, large vessel cervical or intracranial atherosclerosis within the past 10 days
  • Subject is willing and able to undergo study requirements and expected to be geographically stable during study follow-up
  • Subject is 60 years of age or older, or age 50 to 59 years plus a documented medical history of at least one of the following additional risk factors for stroke:
  • Congestive heart failure
  • Hypertension (Systolic Blood Pressure \> 140)
  • Diabetes Mellitus
  • Prior Stroke (\>90 days ago, other than study qualifying index event)
  • Vascular disease (e.g. coronary artery disease, heart attack, peripheral artery disease and complex aortic plaque)

You may not qualify if:

  • Subject has had a cryptogenic stroke
  • Subject has had a cardioembolic stroke
  • Subject has untreated hyperthyroidism
  • Subject has had a recent myocardial infarction \<1 month of stroke
  • Subject has had a recent cardiac surgery (e.g. coronary artery bypass surgery (CABG)) \<1 month of stroke
  • Subject has a mechanical heart valve
  • Subject has valvular disease requiring immediate surgical intervention
  • Subject has documented prior history of atrial fibrillation or atrial flutter
  • Subject has permanent indication for oral anticoagulation
  • Subject has permanent contraindication to oral anticoagulation such that detection of AF would not change medical management, based on enrolling investigators judgment
  • Subject is enrolled in a concurrent study that may confound the results of this study. Co-enrollment in any concurrent clinical study (including registries) requires approval of the study manager or designee.
  • Subject's life expectancy is less than 1 year
  • Subject is pregnant
  • Subject has or is indicated for implant with a pacemaker, Implantable Cardioverter Defibrillator (ICD), Cardiac ResynchronizationTherapy (CRT), or an implantable hemodynamic monitor
  • Subject with a medical condition that precludes the patient from participation in the opinion of the investigator

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (35)

Cardiovascular Associates of the Southeast

Birmingham, Alabama, 35243, United States

Location

Scripps Memorial Hospital La Jolla

La Jolla, California, 92037, United States

Location

University of California San Francisco UCSF Medical Center

San Francisco, California, 94143, United States

Location

Innovative Medical Research of South Florida

Aventura, Florida, 33180, United States

Location

University of Miami Hospital

Miami, Florida, 33136, United States

Location

AdventHealth Neuroscience Institute

Orlando, Florida, 32803, United States

Location

The Queens Medical Center

Honolulu, Hawaii, 96813, United States

Location

Northwestern University

Chicago, Illinois, 60611, United States

Location

Baptist Health Lexington

Lexington, Kentucky, 40503, United States

Location

Norton Neuroscience Institute

Louisville, Kentucky, 40202, United States

Location

Ochsner Medical Center

New Orleans, Louisiana, 70201, United States

Location

Massachusetts General Hospital

Boston, Massachusetts, 02114, United States

Location

Health Partners Institute (Bloomington MN)

Bloomington, Minnesota, 55101, United States

Location

Health Partners Institute (Saint Louis Park MN)

Saint Louis Park, Minnesota, 55426, United States

Location

Cox Medical Center South

Springfield, Missouri, 65807, United States

Location

Mercy Clinic Cardiology

St Louis, Missouri, 63141, United States

Location

Hackensack University Medical Center

Hackensack, New Jersey, 07601, United States

Location

Albany Medical Center

Albany, New York, 12211, United States

Location

University at Buffalo, The State University of New York

Buffalo, New York, 14203, United States

Location

North Shore University Hospital

New Hyde Park, New York, 11030, United States

Location

NYU Langone Medical Center

New York, New York, 10016, United States

Location

Icahn School of Medicine at Mount Sinai

New York, New York, 10029, United States

Location

Overlook Medical Center

Summit, New York, 07901, United States

Location

Cone Health

Greensboro, North Carolina, 27401, United States

Location

The University of Oklahoma Health Sciences Center

Oklahoma City, Oklahoma, 73104, United States

Location

PeaceHealth Sacred Heart Medical Center at Riverbend

Springfield, Oregon, 97477, United States

Location

Lancaster General Hospital

Lancaster, Pennsylvania, 17604, United States

Location

Hospital of the University of Pennsylvania

Philadelphia, Pennsylvania, 19104, United States

Location

Lankenau Institute for Medical Research

Wynnewood, Pennsylvania, 19096, United States

Location

Saint Thomas Research Institute

Nashville, Tennessee, 37205, United States

Location

Baylor Research Institute Dallas - Baylor University Medical Center (BUMC)

Dallas, Texas, 75246, United States

Location

University of Texas (UT) Southwestern Medical Center

Dallas, Texas, 75390, United States

Location

Houston Methodist Hospital

Houston, Texas, 77030, United States

Location

Centra Medical Group Stroobants Cardiovascular Center

Lynchburg, Virginia, 24501, United States

Location

Aurora Saint Luke's Medical Center

Milwaukee, Wisconsin, 53215, United States

Location

Related Publications (4)

  • Bernstein RA, Kamel H, Granger CB, Piccini JP, Katz JM, Sethi PP, Pouliot E, Franco N, Ziegler PD, Schwamm LH; STROKE AF Investigators. Atrial Fibrillation In Patients With Stroke Attributed to Large- or Small-Vessel Disease: 3-Year Results From the STROKE AF Randomized Clinical Trial. JAMA Neurol. 2023 Dec 1;80(12):1277-1283. doi: 10.1001/jamaneurol.2023.3931.

  • Schwamm LH, Kamel H, Granger CB, Piccini JP, Katz JM, Sethi PP, Sidorov EV, Kasner SE, Silverman SB, Merriam TT, Franco N, Ziegler PD, Bernstein RA; STROKE AF Investigators. Predictors of Atrial Fibrillation in Patients With Stroke Attributed to Large- or Small-Vessel Disease: A Prespecified Secondary Analysis of the STROKE AF Randomized Clinical Trial. JAMA Neurol. 2023 Jan 1;80(1):99-103. doi: 10.1001/jamaneurol.2022.4038.

  • Zachrison KS, Amati V, Schwamm LH, Yan Z, Nielsen V, Christie A, Reeves MJ, Sauser JP, Lomi A, Onnela JP. Influence of Hospital Characteristics on Hospital Transfer Destinations for Patients With Stroke. Circ Cardiovasc Qual Outcomes. 2022 May;15(5):e008269. doi: 10.1161/CIRCOUTCOMES.121.008269. Epub 2022 Apr 4.

  • Bernstein RA, Kamel H, Granger CB, Piccini JP, Sethi PP, Katz JM, Vives CA, Ziegler PD, Franco NC, Schwamm LH; STROKE-AF Investigators. Effect of Long-term Continuous Cardiac Monitoring vs Usual Care on Detection of Atrial Fibrillation in Patients With Stroke Attributed to Large- or Small-Vessel Disease: The STROKE-AF Randomized Clinical Trial. JAMA. 2021 Jun 1;325(21):2169-2177. doi: 10.1001/jama.2021.6470.

MeSH Terms

Conditions

Stroke

Condition Hierarchy (Ancestors)

Cerebrovascular DisordersBrain DiseasesCentral Nervous System DiseasesNervous System DiseasesVascular DiseasesCardiovascular Diseases

Limitations and Caveats

The attribution of stroke mechanism is subjective and may have led to the enrollment of a population at higher risk of underlying embolism. However, this attribution reflects real-world practice and our sample is representative of patients in whom ICM decisions need to be made. The assignment to ICM versus control was not blinded, however our study endpoint was adjudicated using objective criteria. Our study was not powered to detect a significant difference in rates of recurrent stroke.

Results Point of Contact

Title
Carola Alfaro Vives
Organization
Medtronic

Study Officials

  • Richard Bernstein, PhD/MD

    Northwestern University

    STUDY CHAIR
  • Lee Schwamm, MD

    Mass General

    STUDY CHAIR

Publication Agreements

PI is Sponsor Employee
No
Restrictive Agreement
No

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
NONE
Purpose
DIAGNOSTIC
Intervention Model
PARALLEL
Model Details: Subjects will be randomized 1:1 to the continuous monitoring arm or the control arm. Subjects randomized to the continuous monitoring arm will have a Reveal LINQ ICM inserted within 10 days of the qualifying stroke and undergo continuous remote monitoring. Subjects randomized to the control arm will be followed per site specific standard of care.
Sponsor Type
INDUSTRY
Responsible Party
SPONSOR

Study Record Dates

First Submitted

March 2, 2016

First Posted

March 7, 2016

Study Start

March 1, 2016

Primary Completion

August 3, 2020

Study Completion

July 28, 2022

Last Updated

May 26, 2023

Results First Posted

November 9, 2021

Record last verified: 2023-04

Data Sharing

IPD Sharing
Will not share

This data is for internal, Medtronic use only. Data from the study will be analyzed and submitted in the form of abstracts and possible publication in a journal.

Locations