SmartWatch-driven AF Detection in Stroke Patients

Inclusion Criteria:

• Study participation in Find-AF 2

• Randomization in the intervention arm of the Find-AF 2 study and presence of animplanted event recorder (Medtronic Reveal LINQTM Insertable Cardiac Monitor)

• Signed informed consent

• All inclusion criteria of the Find-AF 2 study are met (according to protocol versionFinal 4.0, dated 08.05.2024): i. Recent symptomatic ischemic stroke within the last 30 days (sudden focalneurologic deficit lasting > 24 h consistent with the territory of a cerebralartery) If the neurologic deficit lasted < 24 h a corresponding lesion* on brainimaging is needed.

ii. Age ≥ 60 years. iii. Patient without or with only slight disability (modified Rankin Scale score ≤ 2) before onset of stroke-related symtoms.

iv. Written informed consent

• Corresponding lesion can be an acute lesion on diffusion-weighted magnetic resonance imaging, native computed tomography (CT) or CT perfusion imaging or a recent occlusion or intracranial thrombus on angiography (CTA, MRA, DSA)

Exclusion Criteria:

• Expiration of the battery of the event recorder in <3 months

• No in ICM data transmission possible (e. g. missing compliance)

• Poor ECG data quality according to core lab evaluation (e.g. permanent oversensing),which prevents meaningful evaluation of the event recorder data

• Exclusion criteria of the Find-AF 2 study (according to protocol version Final 4.0,dated 08.05.2024): i. Known history of atrial fibrillation/flutter or atrial fibrillation/flutter onadmission ECG.

ii. Current indication or contraindication for oral anticoagulation at randomisation.

iii. Intracerebral bleeding in medical history iv. Patient scheduled for ECG-monitoring lasting > 7 days (Holter-ECG, implanted loop recorder, etc.).

v. Implanted pacemaker device or cardioverter/defibrillator or implanted cardiac monitor.

vi. Patient not willing to be treated with oral anticoagulants vii. Carotid artery stenosis ipsilateral to the current ischemic stroke needing operation or intervention.

viii. History of carotid endarterectomy or percutaneous stent intervention of cerebral or cervical artery within the last 30 days.

ix. Life expectancy <1 year for reasons other than stroke (e.g. metastatic cancer).

x. Patients under legal supervision or guardianship xi. Psychological/mental or other inabilities to supply required information (e.g. fill out the questionnaire due to dementia, language difficulties, ... ) or participate in the required tests xii. Participation in other randomized interventional trials xiii. Suspected lack of compliance