Share
array:24 [ "pii" => "S2387020623002486" "issn" => "23870206" "doi" => "10.1016/j.medcle.2023.03.010" "estado" => "S300" "fechaPublicacion" => "2023-07-21" "aid" => "6216" "copyright" => "Elsevier España, S.L.U.. All rights reserved" "copyrightAnyo" => "2023" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Med Clin. 2023;161:54-8" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "Traduccion" => array:1 [ "es" => array:19 [ "pii" => "S0025775323001409" "issn" => "00257753" "doi" => "10.1016/j.medcli.2023.03.005" "estado" => "S300" "fechaPublicacion" => "2023-07-21" "aid" => "6216" "copyright" => "Elsevier España, S.L.U." "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Med Clin. 2023;161:54-8" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "es" => array:12 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original</span>" "titulo" => "Utilidad del Holter insertable con detección remota en el diagnóstico etiológico del ictus criptogénico: análisis de 73 pacientes" "tienePdf" => "es" "tieneTextoCompleto" => "es" "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "54" "paginaFinal" => "58" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Use of the insertable Holter with remote detection in the etiological diagnosis of cryptogenic stroke: Analysis of 73 patients" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Paula Lobato Casado, Álvaro Jamilena López, Jose Clemente Segundo Rodríguez, Marta Inmaculada Pachón Iglesias, María del Mar Morín Martín, Miguel Ángel Arias Palomares" "autores" => array:6 [ 0 => array:2 [ "nombre" => "Paula" "apellidos" => "Lobato Casado" ] 1 => array:2 [ "nombre" => "Álvaro" "apellidos" => "Jamilena López" ] 2 => array:2 [ "nombre" => "Jose Clemente" "apellidos" => "Segundo Rodríguez" ] 3 => array:2 [ "nombre" => "Marta Inmaculada" "apellidos" => "Pachón Iglesias" ] 4 => array:2 [ "nombre" => "María del Mar" "apellidos" => "Morín Martín" ] 5 => array:2 [ "nombre" => "Miguel Ángel" "apellidos" => "Arias Palomares" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S2387020623002486" "doi" => "10.1016/j.medcle.2023.03.010" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2387020623002486?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0025775323001409?idApp=UINPBA00004N" "url" => "/00257753/0000016100000002/v1_202307131046/S0025775323001409/v1_202307131046/es/main.assets" ] ] "itemSiguiente" => array:18 [ "pii" => "S2387020623002632" "issn" => "23870206" "doi" => "10.1016/j.medcle.2023.04.010" "estado" => "S300" "fechaPublicacion" => "2023-07-21" "aid" => "6248" "copyright" => "Elsevier España, S.L.U." "documento" => "article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Med Clin. 2023;161:59-61" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:12 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>" "titulo" => "Outcomes of vaccinated versus unvaccinated COVID-19 patients in Israel during the Omicron and Delta waves—A retrospective cohort study" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "59" "paginaFinal" => "61" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Resultados de pacientes con COVID-19 vacunados vs. no vacunados en Israel durante las olas de ómicron y delta: Un estudio de cohorte retrospectivo" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Itamar Poran, Amjaad Abu Mokh, Daniella Vronsky, Genady Drozdinsky, Bar Basharim, Noa Eliakim-Raz" "autores" => array:6 [ 0 => array:2 [ "nombre" => "Itamar" "apellidos" => "Poran" ] 1 => array:2 [ "nombre" => "Amjaad Abu" "apellidos" => "Mokh" ] 2 => array:2 [ "nombre" => "Daniella" "apellidos" => "Vronsky" ] 3 => array:2 [ "nombre" => "Genady" "apellidos" => "Drozdinsky" ] 4 => array:2 [ "nombre" => "Bar" "apellidos" => "Basharim" ] 5 => array:2 [ "nombre" => "Noa" "apellidos" => "Eliakim-Raz" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2387020623002632?idApp=UINPBA00004N" "url" => "/23870206/0000016100000002/v1_202307241700/S2387020623002632/v1_202307241700/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S2387020623002796" "issn" => "23870206" "doi" => "10.1016/j.medcle.2023.02.018" "estado" => "S300" "fechaPublicacion" => "2023-07-21" "aid" => "6218" "copyright" => "Elsevier España, S.L.U." "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Med Clin. 2023;161:49-53" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:12 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>" "titulo" => "Prevalence and pattern of alcohol consumption in patients with hepatocellular carcinoma" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "49" "paginaFinal" => "53" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Prevalencia y patrón de consumo de alcohol en pacientes con carcinoma hepatocelular" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Daniel Muiño-Domínguez, Alejandro Mínguez-Sabater, Eduardo Junquera-Alonso, Ana María Piedra-Cerezal, Manuel Rodríguez, María Varela" "autores" => array:6 [ 0 => array:2 [ "nombre" => "Daniel" "apellidos" => "Muiño-Domínguez" ] 1 => array:2 [ "nombre" => "Alejandro" "apellidos" => "Mínguez-Sabater" ] 2 => array:2 [ "nombre" => "Eduardo" "apellidos" => "Junquera-Alonso" ] 3 => array:2 [ "nombre" => "Ana María" "apellidos" => "Piedra-Cerezal" ] 4 => array:2 [ "nombre" => "Manuel" "apellidos" => "Rodríguez" ] 5 => array:2 [ "nombre" => "María" "apellidos" => "Varela" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0025775323001422" "doi" => "10.1016/j.medcli.2023.02.015" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0025775323001422?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2387020623002796?idApp=UINPBA00004N" "url" => "/23870206/0000016100000002/v1_202307241700/S2387020623002796/v1_202307241700/en/main.assets" ] "en" => array:18 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>" "titulo" => "Use of the insertable Holter with remote detection in the etiological diagnosis of cryptogenic stroke: Analysis of 73 patients" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "54" "paginaFinal" => "58" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Paula Lobato Casado, Álvaro Jamilena López, Jose Clemente Segundo Rodríguez, Marta Inmaculada Pachón Iglesias, María del Mar Morín Martín, Miguel Ángel Arias Palomares" "autores" => array:6 [ 0 => array:4 [ "nombre" => "Paula" "apellidos" => "Lobato Casado" "email" => array:1 [ 0 => "paulalobatocasado@gmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Álvaro" "apellidos" => "Jamilena López" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "Jose Clemente" "apellidos" => "Segundo Rodríguez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 3 => array:3 [ "nombre" => "Marta Inmaculada" "apellidos" => "Pachón Iglesias" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 4 => array:3 [ "nombre" => "María del Mar" "apellidos" => "Morín Martín" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 5 => array:3 [ "nombre" => "Miguel Ángel" "apellidos" => "Arias Palomares" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Unidad de Ictus, Servicio de Neurología, Complejo Hospitalario Universitario de Toledo, Toledo, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Unidad de Arritmias y Electrofisiología Cardiaca, Servicio de Cardiología, Complejo Hospitalario Universitario de Toledo, Toledo, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Utilidad del Holter insertable con detección remota en el diagnóstico etiológico del ictus criptogénico: análisis de 73 pacientes" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Atrial fibrillation (AF) is the most common cause of cardioembolic stroke. It accounts for one third of ischaemic strokes and its prevalence increases with age. These are potentially life-threatening strokes with greater sequelae, with a higher incidence in the female population. Therefore, early detection is essential to avoid recurrences due to the implications in the change of secondary prevention strategies.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> The search for silent AF after a stroke is a process that begins with conventional electrocardiographic monitoring during admission, with the time, intensity and duration of this search varying according to the options each centre has for continuous monitoring. Clinical practice shows that, as a result of the short duration of conventional Holter monitoring methods, AF is detected in only 2–3% of cryptogenic strokes.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> However, if implantable cardiac monitoring devices are used in strokes with an embolic origin, this rate increases to 30% according to the series.<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> Although data from studies are heterogeneous, evidence strongly suggests that more sophisticated and longer duration monitoring methods are associated with an increased rate of subclinical paroxysmal AF detection.</p><p id="par0010" class="elsevierStylePara elsevierViewall">When faced with a stroke with an embolic territorial origin, suggesting a plausible cardiac origin based on initial tests, detecting paroxysmal AF during prolonged monitoring usually provides the neurologist with the certainty of having detected the original cause, allowing for a change in treatment strategy. However, there are alternative hypotheses for the development of AF after a stroke, with AF being a mere bystander. Given that they share cardiovascular risk factors, AF may coexist with intra- or extracranial atherosclerosis, in which case it may only be a co-morbidity. This theory is supported by the fact that an independent direct cause is found in about 15% of strokes with AF. Furthermore, approximately 10% of lacunar strokes, with a completely different etiopathogenic mechanism, also have AF.<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> Another hypothesis is that AF is secondary to involvement of the autonomic nervous system when the insula, frontal regions or the brainstem are damaged.</p><p id="par0015" class="elsevierStylePara elsevierViewall">Markers of abnormal atrial tissue and associated electrical changes have been linked to embolic strokes.<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> Such atrial tissue abnormalities predispose to dilatation, myocyte changes, endothelial dysfunction, fibrosis and inflammation, which favour thrombus formation. Left atrial thromboembolism comprises a complex interaction of systemic cardiovascular risk factors, atrial tissue damage substrate and arrhythmia in what has been defined as atrial cardiomyopathy.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> A comprehensive study of these alterations is relevant to try to select patients who would benefit from prolonged monitoring.</p><p id="par0020" class="elsevierStylePara elsevierViewall">The present study analyses a protocol developed in our centre in 2017 for selecting stroke patients who are candidates for prolonged monitoring using an implantable Holter with remote detection.</p><p id="par0025" class="elsevierStylePara elsevierViewall">We believe that such screening, based on epidemiological, clinical, imaging, echocardiographic and electrocardiographic criteria, can serve to better select the patient as a candidate for such monitoring, thereby optimising costs and providing a better understanding of the underlying pathophysiological mechanisms.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Objective</span><p id="par0030" class="elsevierStylePara elsevierViewall">To define variables that are related to and can predict the presence of paroxysmal AF in patients with cryptogenic stroke or embolic stroke with risk factors for atrial cardiomyopathy in order to select patients who are candidates for prolonged monitoring with an implantable device.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Patients and methods</span><p id="par0035" class="elsevierStylePara elsevierViewall">The study population are patients who had a cryptogenic ischaemic stroke and underwent implantable Holter monitoring for suspected silent AF.</p><p id="par0040" class="elsevierStylePara elsevierViewall">Such a cryptogenic stroke must fall into one of the following 2 groups: (1) cryptogenic stroke due to coexistence of 2 or more aetiologies in which, either by symptoms or by findings in complementary tests, there is a high suspicion of cardioembolic aetiology; (2) cryptogenic stroke due to unknown cause after a comprehensive study.</p><p id="par0045" class="elsevierStylePara elsevierViewall">The device used is Medtronic's Reveal LINQ™ with automatic AF detection using the CareLink™ system based on the TruRhythm detection algorithm™.</p><p id="par0050" class="elsevierStylePara elsevierViewall">Device implantation was performed before discharge or early after stroke, in agreement with the Electrophysiology Unit.</p><p id="par0055" class="elsevierStylePara elsevierViewall">Patients were selected from March 2017 to May 2022 and must have been on implantable Holter monitoring for at least one year in order to be included in the study.</p><p id="par0060" class="elsevierStylePara elsevierViewall">To determine the predictors of AF in patients with implantable Holter monitoring with cryptogenic ischaemic stroke, the following variants were considered: age, cardiovascular risk factors (hypertension, diabetes, dyslipidaemia, active or ex-smoker), type of stroke (divided into large vessel [carotid, middle cerebral segments M1 and M2 proximal, basilar], cortical [middle cerebral segments M2 distal and M3, posterior cerebral and anterior and posterior cerebellar], multi-infarct [involvement of 2 or more territories in different progression stages]), presence of patent foramen ovale (and if associated with facilitating anatomy: hypermobile interatrial septum and interatrial septal aneurysm), acute stroke treatment (fibrinolysis and thrombectomy), presence of atrial dilatation (diameter greater than 38 mm in women and 40 mm in men, as well as its level of severity) and the presence of high-rate supraventricular tachycardia (SVT) by conventional Holter (high density considered above 1% of total beats).</p><p id="par0065" class="elsevierStylePara elsevierViewall">For the statistical study, the mean and standard deviation were used for the descriptive analysis. To establish whether there is dependence between the qualitative variable under study (in this case, the presence or not of AF) and the different independent variables, a bivariate analysis was performed using Chi-square for all of them, except for the independent variables of presence or absence of patent foramen ovale, large vessel stroke and existence or not of high-rate SVT, in which Fisher's exact test was used.</p><p id="par0070" class="elsevierStylePara elsevierViewall">A binary logistic regression test and the determination of the area under the curve were used to create the predictive model (only those variables in the model that showed statistical significance were taken into consideration, eliminating those that did not show statistical significance or did not increase in significance with respect to the previous ones). We considered a value of p < 0.05 to be significant.</p><p id="par0075" class="elsevierStylePara elsevierViewall">Data were collected and analysed using the SPSS® 25 statistical software for Mac (IBM®).</p><p id="par0080" class="elsevierStylePara elsevierViewall">Anticoagulation treatment was initiated within 24 h of detection of the arrhythmia if it was detected by telephone or within a short period of time if the arrhythmia was detected face-to-face.</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Results</span><p id="par0085" class="elsevierStylePara elsevierViewall">The total number of patients included in the study was 73, with a mean age of 58.85 years (±12.8). Of the total number of patients, 41 were male (56.2%). AF was detected during follow-up in 21 patients (28.8%).</p><p id="par0090" class="elsevierStylePara elsevierViewall">The cardiovascular risk factors included were hypertension (35 patients, 47%), diabetes mellitus (12 patients, 16%), dyslipidaemia (33 patients, 45.2%) and smoking (29 patients, 39.7%).</p><p id="par0095" class="elsevierStylePara elsevierViewall">Among the stroke types, 38 were cortical (52%), 22 multi-territorial (30%), 10 large vessel (13.7%) and 3 (4%) lacunar strokes. Regarding echocardiographic parameters, 16 patients (22%) had a dilated atrium, 11 (69%) were within a mildly dilated range. The total number of patients with patent foramen ovale was 14 (19%), of which 10 (14%) had a facilitating anatomy associated with the foramen.</p><p id="par0100" class="elsevierStylePara elsevierViewall">Finally, conventional 24 h Holter monitoring revealed that 14 (22%) had a high-rate SVT. The characteristics of the sample are set out in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>.</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0105" class="elsevierStylePara elsevierViewall">The bivariate analysis showed a statistically significant relationship between the detection of AF and age over 65 years, arterial hypertension and the presence of high-rate SVT in the 24 h Holter (<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>). A multivariate analysis was performed to find out whether any of these variables was a true predictor of AF in these patients. Said analysis revealed that the only predictor variable was the presence of SVT (OR 37.237) with an area under the curve of 0.762 (95% confidence interval 0.57−0.87, p = 0.04).</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0110" class="elsevierStylePara elsevierViewall">In our case, the presence of high-rate SVT for the diagnosis of paroxysmal AF in the context of cryptogenic stroke has a sensitivity of 47.6%, a specificity of 97.5%, a positive predictive value of 90.9%, a negative predictive value of 78.8% and an accuracy of 80.9%.</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Discussion</span><p id="par0115" class="elsevierStylePara elsevierViewall">The aim of this study is to combine different clinical, neuroimaging, electrophysiological and echocardiographic variables to try to develop consistent predictors to identify silent arrhythmias responsible for cryptogenic stroke and to establish early and appropriate secondary prevention treatment.</p><p id="par0120" class="elsevierStylePara elsevierViewall">Consistent with what has been described in previous literature, the bivariate analysis shows a statistically significant relationship between the detection of AF and age over 65 years, arterial hypertension and the presence of high-rate SVT in the 24 h Holter, the latter being the only variable that can predict silent AF in patients with cryptogenic stroke, with a specificity of 97.6% and a positive predictive value of 90.9%.</p><p id="par0125" class="elsevierStylePara elsevierViewall">Since the emergence of the still controversial embolic stroke of undetermined source (ESUS), which is a subtype of cryptogenic stroke associated with a recurrence risk of 3–6% per year,<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a> parallel clinical trials based on anticoagulation as secondary prevention have been developed without objective evidence of AF. Two large, randomised trials, NAVIGATE-ESUS with rivaroxaban<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a> and RE-SPECT-ESUS with dabigatran,<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a> demonstrated no benefit of anticoagulation using direct-acting oral anticoagulants compared to antiplatelet therapy in patients with ESUS. Subsequent meta-analyses of these have identified an accumulation of factors that argue in favour of anticoagulation therapy. In NAVIGATE-ESUS it was both left ventricular disease and left atrial enlargement, and in RE-SPECT-ESUS it was advanced age.</p><p id="par0130" class="elsevierStylePara elsevierViewall">Within ESUS, there is a subgroup of cardioembolic origin<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a> that could benefit from anticoagulant therapy and are candidates for intensive search for subclinical AF. It should be remembered that there are other less common embolic sources other than AF (patent foramen ovale, aortic atherosclerosis, prothrombotic states associated with tumours). For this reason, it is advisable to carry out a comprehensive aetiological study to rule out other responsible sources, as part of the workup of the cryptogenic stroke with an embolic origin.</p><p id="par0135" class="elsevierStylePara elsevierViewall">In our series of patients, the selection and aetiological study, as described above, was thorough, allowing us to classify them as cryptogenic strokes or ESUS.</p><p id="par0140" class="elsevierStylePara elsevierViewall">Continuous cardiac monitoring by implantable Holter monitor in patients with ESUS or cryptogenic stroke has demonstrated silent paroxysmal AF in 10% at 6 months, increasing to 30% at 3 years.<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a> Those with a delayed detection of AF were at 1.5 fold greater risk of recurrence.<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">11</span></a></p><p id="par0145" class="elsevierStylePara elsevierViewall">Previous studies have identified predictors of AF such as: clinical features,<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">12</span></a> neuroimaging evidence (multiple acute infarctions), echocardiographic abnormalities (size, volume, presence of fibrosis or left atrial function),<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">12</span></a> biomarkers (troponin, natriuretic peptides or Von Villebrand factor),<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a> electrocardiographic monitoring findings (terminal P wave strength in V1, episodes of atrial tachyarrhythmia, common supraventricular extrasystoles, premature beats and interatrial block).<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">13</span></a> With respect to electrocardiographic abnormalities predictive of silent AF, Bayes syndrome is of particular interest. This syndrome is characterised by advanced, usually subclinical, interatrial block. It is defined electrocardiographically as a prolonged P wave duration greater than 120 ms with biphasic morphology in inferior leads. It is a predictor of increased risk of AF and is independently associated with an increased risk of non-lacunar embolic stroke. It is a cause of silent ischaemia and cognitive impairment of vascular origin.<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">14</span></a></p><p id="par0150" class="elsevierStylePara elsevierViewall">Based on previous studies, the profile of patients who develop AF tends to be older, have a history of coronary heart disease, hypertension and renal involvement, which translates into higher CHA2DS2-VASc scores.<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">15</span></a> Age 70 years or older is the strongest predictor for the development of AF.</p><p id="par0155" class="elsevierStylePara elsevierViewall">Attempts have been made to develop different scales to predict the risk of AF after a stroke, including the HAVOC score (risk of AF based on hypertension, age over 75 years, valvular heart disease, peripheral artery disease, obesity, heart failure and coronary artery disease<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">16</span></a>) and the NDAF score (assesses: age over 72 years, coronary artery disease or stroke, left atrial area greater than or equal to 16 cm<span class="elsevierStyleSup">2</span><a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">17</span></a>). The HAVOC score has been validated in a large cohort (n = 9589) and stratifies risk in patients with cryptogenic stroke or TIA into low, medium and high risk of AF.<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">16</span></a></p><p id="par0160" class="elsevierStylePara elsevierViewall">In the light of these data, further study of a possible cardioembolic origin is recommended in patients at risk on the basis of these scores, especially in those in whom intra- or extracranial atherosclerosis has not been shown to be a possible causative mechanism.</p><p id="par0165" class="elsevierStylePara elsevierViewall">Regarding the site of stroke, it should be noted that cortical and cerebellar stroke have been associated with a 3-fold increased risk of AF<a class="elsevierStyleCrossRefs" href="#bib0090"><span class="elsevierStyleSup">18,19</span></a>; multifocal infarcts and haemorrhagic transformation of stroke through a reperfusion mechanism<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">19</span></a> have been associated with a probable embolic aetiology. However, a post hoc analysis of CRISTAL-AF showed that the detection of a first AF episode did not correlate with the radiological pattern.<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">20</span></a></p><p id="par0170" class="elsevierStylePara elsevierViewall">NT-proBNP<a class="elsevierStyleCrossRefs" href="#bib0105"><span class="elsevierStyleSup">21,22</span></a> has been evaluated as a biomarker, and its elevation was found to carry an increased risk of developing AF, identifying an elevation of 5 times the normal value compared to non-cardioembolic strokes. It is believed that this marker may confer the highest yield to be a candidate for prolonged monitoring, in addition to advanced age and hypertension. It could not be included in our study because a baseline acute-phase natriuretic peptide measurement was not available in all patients.</p><p id="par0175" class="elsevierStylePara elsevierViewall">The presence of cerebral atrophy correlates with the presence of small vessel cerebrovascular disease with subsequent frontal subcortical cognitive impairment.<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">23</span></a> It is known that AF and cognitive impairment are clinical conditions that share similar risk factors, so a future line of research could be related to determining the relationship between cerebral atrophy and silent AF, similar to how it has been assessed with small-vessel vascular disease.</p><p id="par0180" class="elsevierStylePara elsevierViewall">With respect to the prolonged monitoring method, the implantable device provides a longer monitoring time. The fact that it is implanted during the patient's admission and performed before discharge provides continuous post-stroke monitoring with optimal recording quality.</p><p id="par0185" class="elsevierStylePara elsevierViewall">Intermediate methods such as wearable or external monitoring with variable duration prior to implantation have been proposed if the patient is at risk and has been negative for AF detection. The detection rate of implantable Holter recordings is more sensitive compared to external Holter recordings, and up to 30% in cryptogenic stroke, as previously described.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a></p><p id="par0190" class="elsevierStylePara elsevierViewall">Regarding AF duration, the device implanted in our patients automatically detects an AF duration longer than 2 min, and longer than 30 s in CRISTAL-AF, unless manually activated by the patient. As previously mentioned, subclinical or silent AF detected after stroke may be a mere bystander and the relevance of its duration is a matter of controversy.</p><p id="par0195" class="elsevierStylePara elsevierViewall">Due to close communication with Cardiology, our centre has opted for the subcutaneous implantation of prolonged Holter, which we believe has been essential in the development of the protocol and its early implantation.</p><p id="par0200" class="elsevierStylePara elsevierViewall">Limitations of the present study may arise from the sample size and the absence of biomarkers such as NT-proBNP, as this measurement was not available in all patients.</p><p id="par0205" class="elsevierStylePara elsevierViewall">However, more studies are needed to identify markers or variables that could be predictive of such an arrhythmia in order to find the ideal candidate for prolonged monitoring.</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Funding</span><p id="par0210" class="elsevierStylePara elsevierViewall">There are no sources of full or partial funding in the development of this original article.</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Conflict of interest</span><p id="par0215" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflicts of interest.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:12 [ 0 => array:3 [ "identificador" => "xres1938362" "titulo" => "Abstract" "secciones" => array:5 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Introduction" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Objective" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Patients and methods" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Results" ] 4 => array:2 [ "identificador" => "abst0025" "titulo" => "Conclusions" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec1670380" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres1938361" "titulo" => "Resumen" "secciones" => array:5 [ 0 => array:2 [ "identificador" => "abst0030" "titulo" => "Introducción" ] 1 => array:2 [ "identificador" => "abst0035" "titulo" => "Objetivo" ] 2 => array:2 [ "identificador" => "abst0040" "titulo" => "Pacientes y métodos" ] 3 => array:2 [ "identificador" => "abst0041" "titulo" => "Resultados" ] 4 => array:2 [ "identificador" => "abst0045" "titulo" => "Conclusiones" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec1670379" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:2 [ "identificador" => "sec0010" "titulo" => "Objective" ] 6 => array:2 [ "identificador" => "sec0015" "titulo" => "Patients and methods" ] 7 => array:2 [ "identificador" => "sec0020" "titulo" => "Results" ] 8 => array:2 [ "identificador" => "sec0025" "titulo" => "Discussion" ] 9 => array:2 [ "identificador" => "sec0030" "titulo" => "Funding" ] 10 => array:2 [ "identificador" => "sec0035" "titulo" => "Conflict of interest" ] 11 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2022-12-12" "fechaAceptado" => "2023-03-15" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec1670380" "palabras" => array:6 [ 0 => "Atrial fibrillation" 1 => "Cryptogenic stroke" 2 => "Embolic stroke" 3 => "Holter monitoring" 4 => "Secondary prevention" 5 => "Supraventricular tachycardia" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec1670379" "palabras" => array:6 [ 0 => "Fibrilación auricular" 1 => "Ictus criptogénico" 2 => "Ictus embólico" 3 => "Monitorización Holter" 4 => "Prevención secundaria" 5 => "Taquicardia supraventricular" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:3 [ "titulo" => "Abstract" "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Introduction</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Cryptogenic stroke constitutes 25% of all ischemic strokes, of which 20–30% are due to atrial fibrillation (AF). With the aim of increasing the detection rate, implantable long-term monitoring devices have emerged. The study of the profile of the ideal candidate subsidiary to such monitoring would provide a better understanding of the mechanisms underlying this subtype of stroke.</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Objective</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">To determine which variables are related and can predict the detection of silent AF in patients with cryptogenic stroke.</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Patients and methods</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">This is a longitudinal cohort with recruitment from March 2017 to May 2022. They are patients with an implantable monitoring device and cryptogenic stroke with a minimum monitoring of one year.</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Results</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">The total number of patients included was 73, with a mean age of 58.8 years, 56.2% were male. AF was detected in 21 patients (28.8%). The most frequent cardiovascular risk factors were hypertension (47.9%) and dyslipidemia (45.2%). The most frequent topography was cortical (52%). Regarding the echocardiographic parameters, 22% had a dilated left atrium, 19% had a patent foramen ovale, and 22% had high-density supraventricular tachycardia (SVT) (>1%) on Holter monitoring. In the multivariate analysis, the only variable that predicts AF is the presence of highdensity SVT, with an area under the curve of 0.726 (CI 0.57;0.87, p = 0.04), sensitivity of 47.6%, specificity of 97.5%, positive predictive value of 90.9%, negative predictive value of 78.8%, and accuracy of 80.9%.</p></span> <span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Conclusions</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">The presence of high-density SVT can be indicative for predicting silent AF. No other variables have been observed that allow us to predict detection of AF in these patients.</p></span>" "secciones" => array:5 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Introduction" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Objective" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Patients and methods" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Results" ] 4 => array:2 [ "identificador" => "abst0025" "titulo" => "Conclusions" ] ] ] "es" => array:3 [ "titulo" => "Resumen" "resumen" => "<span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Introducción</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">El ictus criptogénico constituye el 25% del total de ictus isquémicos, de los cuales un 20–30%, son debidos a fibrilación auricular (FA). Con el objetivo de aumentar la tasa de detección, surgen los dispositivos de monitorización prolongada implantables. El estudio del perfil de candidato ideal subsidiario de dicha monitorización otorgaría un mejor entendimiento de los mecanismos que subyacen en este subtipo de ictus.</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Objetivo</span><p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Determinar que variables están relacionadas y puedan predecir la detección de FA silente en pacientes con ictus criptogénico.</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Pacientes y métodos</span><p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Se trata de una cohorte longitudinal con reclutamiento desde marzo de 2017 hasta mayo 2022. Son pacientes portadores de dispositivo de monitorización implantable e ictus criptogénico con monitorización mínima de un año.</p></span> <span id="abst0041" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0051">Resultados</span><p id="spar0061" class="elsevierStyleSimplePara elsevierViewall">El total de pacientes incluidos fue de 73, con edad media de 58,8 años, siendo el 56,2% varones. Se detectó FA en 21 pacientes (28,8%). Los factores de riesgo cardiovascular más frecuentes fueron hipertensión (47,9%) y dislipemia (45,2%). La topografía más frecuente fue cortical (52%). En cuanto a los parámetros ecocardiográficos, 22% tenían la aurícula izquierda dilatada, 19% tenían foramen oval permeable y un 22% presentaron taquicardia supraventricular (TSV) de alta densidad (>1%) en el Holter. En el análisis multivariante la única variable que predictora de FA es la presencia TSV de alta densidad, con un área bajo la curva de 0,726 (IC 0.57;0.87, p = 0.04), una sensibilidad del 47,6%, una especificidad del 97,5%, un valor predictivo positivo del 90,9%, un valor predictivo negativo del 78,8% y una exactitud del 80,9%.</p></span> <span id="abst0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Conclusiones</span><p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">La presencia de TSV de alta densidad puede ser orientativo para predecir FA silente. No se han objetivado otras variables que nos permitan predecir detección de FA en estos pacientes.</p></span>" "secciones" => array:5 [ 0 => array:2 [ "identificador" => "abst0030" "titulo" => "Introducción" ] 1 => array:2 [ "identificador" => "abst0035" "titulo" => "Objetivo" ] 2 => array:2 [ "identificador" => "abst0040" "titulo" => "Pacientes y métodos" ] 3 => array:2 [ "identificador" => "abst0041" "titulo" => "Resultados" ] 4 => array:2 [ "identificador" => "abst0045" "titulo" => "Conclusiones" ] ] ] ] "multimedia" => array:2 [ 0 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">SD: standard deviation.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Total number of patients</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">73 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Sex, n (%)</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Male \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">41 (56.2) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Female \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">32 (43.8) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Average age ± SD, years</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">58.85 ± 12 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Under 45 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">13 ± 17.8 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Between 45 and 60 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">23 ± 31.5 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Over 65 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">37 ± 50.6 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Detection of atrial fibrillation, n (%)</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">21 (28.8) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Cardiovascular risk factors, n (%)</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Hypertension \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">35 (47.9) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Diabetes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">12 (16.4) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Dyslipidaemia \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">33 (45.2) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Active smoker or ex-smoker \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">29 (39.7) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">History of ischaemic heart disease, n (%)</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 (1.3) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Patent foramen ovale</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">14 (19.2) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Associated with facilitating anatomy (hypermobile septum and/or atrial septal aneurysm), n (%)</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">10 (13.6) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Revascularisation treatment, n (%)</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>No treatment \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">52 (71.2) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Intravenous fibrinolysis \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">13 (17.8) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Rescue mechanical thrombectomy \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 (5.5) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Primary mechanical thrombectomy \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 (5.5) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Stroke topography, n (%)</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Cortical \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">38 (52.1) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Multi-territory \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">22 (30.1) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Large vessel \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">10 (13.7) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Lacunar \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 (4.1) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Atrial dilatation, n (%)</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">16 (21.9) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Mild \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">11 (15.1) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Moderate \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 (2.7) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Severe \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 (4.1) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">High density supraventricular tachycardia on Holter 24 h, n (%)</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">11 (17.5) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Modified Rankin Scale score at 3 months, n (%)</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>0−1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">67 (91.8) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 (5.5) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>3−5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 (2.7) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 (1.3) \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab3229158.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Characteristics of cryptogenic stroke patients with an implantable cardiac monitoring device.</p>" ] ] 1 => array:8 [ "identificador" => "tbl0010" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0010" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:3 [ "leyenda" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">AF: atrial fibrillation.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Characteristics of the sample \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">AF detected, n (%) \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">AF undetected, n (%) \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">p \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " colspan="4" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Sex</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Male \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">11 (26.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">30 (73.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.679 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Female \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">10 (30.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">22 (69.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.679 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " colspan="4" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Age, years</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Under 45 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 (7.6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">12 (92.4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.092 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Between 45 and 60 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 (17.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">19 (82.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.174 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Over 65 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">16 (43.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">21 (56.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.006<a class="elsevierStyleCrossRef" href="#tblfn0005">*</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Hypertension</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">38 (52.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">35 (47.9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.042<a class="elsevierStyleCrossRef" href="#tblfn0005">*</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Diabetes</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">12 (16.4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">61 (83.6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.075 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Dyslipidaemia</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">33 (45.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">40 (54.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.193 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Active smoker or ex-smoker</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">29 (39.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">44 (60.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.381 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Patent foramen ovale</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">14 (19.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">59 (80.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.744 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>With facilitating anatomy \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">10 (13.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">57 (85.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.260 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " colspan="4" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Revascularisation treatment</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>No treatment \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">15 (28.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">37 (71.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.981 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Fibrinolysis \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 (33.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8 (66.6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.734 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Rescue thrombectomy \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 (25) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 (75) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Primary thrombectomy \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 (25) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 (75) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " colspan="4" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Stroke topography</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Cortical \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">13 (34.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">25 (65.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.284 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Multi-territorial \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7 (31.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">15 (68.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.781 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Large vessel \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 (10) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">9 (90) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.263 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Lacunar \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 (0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 (100) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.552 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Atrial dilatation</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7 (43.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">9 (56.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.209 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Supraventricular tachycardia > 1% on Holter 24 h</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">10 (90.9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 (9.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><0.001<a class="elsevierStyleCrossRef" href="#tblfn0005">*</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab3229157.png" ] ] ] "notaPie" => array:1 [ 0 => array:3 [ "identificador" => "tblfn0005" "etiqueta" => "*" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">p less than 0.05.</p>" ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Comparison between cryptogenic stroke patients with implantable cardiac monitoring device with and without atrial fibrillation detection.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:23 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Searching for atrial fibrillation poststroke: a white paper of the AF-SCREEN International Collaboration" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "R.B. Schnabel" 1 => "K.G. Haeusler" 2 => "J.S. Healey" 3 => "B. Freedman" 4 => "G. Boriani" 5 => "J. Brachmann" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1161/CIRCULATIONAHA.119.040267" "Revista" => array:6 [ "tituloSerie" => "Circulation" "fecha" => "2019" "volumen" => "140" "paginaInicial" => "1834" "paginaFinal" => "1850" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/31765261" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Cryptogenic stroke and underlying atrial fibrillation" "autores" => array:1 [ 0 => array:3 [ "colaboracion" => "CRYSTAL AF Investigators" "etal" => true "autores" => array:6 [ 0 => "T. Sanna" 1 => "H.C. Diener" 2 => "R.S. Passman" 3 => "V. Di Lazzaro" 4 => "R.A. Bernstein" 5 => "C.A. Morillo" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1056/NEJMoa1313600" "Revista" => array:6 [ "tituloSerie" => "N Engl J Med" "fecha" => "2014" "volumen" => "370" "paginaInicial" => "2478" "paginaFinal" => "2486" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24963567" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Undetermined source in the Athens Stroke Registry: an outcome analysis" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "G. Ntaios" 1 => "V. Papavasileiou" 2 => "H. Milionis" 3 => "K. Makaritsis" 4 => "A. Vemmou" 5 => "E. Koroboki" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1161/STROKEAHA.115.009334" "Revista" => array:6 [ "tituloSerie" => "Stroke" "fecha" => "2015" "volumen" => "46" "paginaInicial" => "2087" "paginaFinal" => "2093" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26159795" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0020" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Small deep infarction in patients with atrial fibrillation: evidence of lacunar pathogenesis" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "Y.S. Park" 1 => "P.W. Chung" 2 => "Y.B. Kim" 3 => "H.S. Moon" 4 => "B.C. Suh" 5 => "W.T. Yoon" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.hrthm.2016.05.028" "Revista" => array:6 [ "tituloSerie" => "Cerebrovasc Dis" "fecha" => "2013" "volumen" => "36" "paginaInicial" => "205" "paginaFinal" => "210" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24135531" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0025" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Electrocardiographic left atrial abnormality and risk of stroke: Northern Manhattan Study" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "H. Kamel" 1 => "M. Hunter" 2 => "Y.P. Moon" 3 => "S. Yaghi" 4 => "K. Cheung" 5 => "M. Di Tullio" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1161/STROKEAHA.115.009989" "Revista" => array:5 [ "tituloSerie" => "Stroke" "fecha" => "2015" "volumen" => "46" "paginaInicial" => "3208" "paginaFinal" => "3212" ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0030" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "HRA/HRS/APHRS/SOLAECE expert consensus on atrial cardiomyopathies: definition, characterization, and clinical implication" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A. Goette" 1 => "J.M. Kalman" 2 => "L. Aguinaga" 3 => "J. Akar" 4 => "J.A. Cabrera" 5 => "S.A. Chen" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.hrthm.2016.05.028" "Revista" => array:6 [ "tituloSerie" => "Heart Rhythm" "fecha" => "2017" "volumen" => "14" "paginaInicial" => "e3" "paginaFinal" => "e40" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27320515" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0035" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Embolic strokes of undetermined source: the case for a new clinical construct" "autores" => array:1 [ 0 => array:3 [ "colaboracion" => "Cryptogenic Stroke/ESUS International Working Group" "etal" => true "autores" => array:6 [ 0 => "R.G. Hart" 1 => "H.C. Diener" 2 => "S.B. Coutts" 3 => "J.D. Easton" 4 => "C.B. Granger" 5 => "M.J. O’Donnell" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/S1474-4422(13)70310-7" "Revista" => array:6 [ "tituloSerie" => "Lancet Neurol" "fecha" => "2014" "volumen" => "13" "paginaInicial" => "429" "paginaFinal" => "438" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24646875" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0040" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Rivaroxaban for stroke prevention after embolic stroke of undetermined source" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "R.G. Hart" 1 => "M. Sharma" 2 => "H. Mundl" 3 => "S.E. Kasner" 4 => "S.I. Bangdiwala" 5 => "S.D. Berkowitz" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1056/NEJMoa1802686" "Revista" => array:6 [ "tituloSerie" => "N Engl J Med" "fecha" => "2018" "volumen" => "378" "paginaInicial" => "2191" "paginaFinal" => "2201" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29766772" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0045" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Dabigatran for prevention of stroke after embolic stroke of undetermined source" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "H.C. Diener" 1 => "R.L. Sacco" 2 => "J.D. Easton" 3 => "C.B. Granger" 4 => "R.A. Bernstein" 5 => "S. Uchiyama" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1056/NEJMoa1813959" "Revista" => array:6 [ "tituloSerie" => "N Engl J Med" "fecha" => "2019" "volumen" => "380" "paginaInicial" => "1906" "paginaFinal" => "1917" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/31091372" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0050" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Optimización de la detección de fibrilación auricular subclínica tras un ESUS" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "J. Masjuán" 1 => "M. Sanmartín-Fernández" 2 => "I. Ferreira-González" 3 => "C.A. Molina" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.33588/rn.7301.2020630" "Revista" => array:5 [ "tituloSerie" => "Rev Neurol" "fecha" => "2021" "volumen" => "73" "paginaInicial" => "26" "paginaFinal" => "34" ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib0055" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Delayed diagnosis of atrial fibrillation after first-ever stroke increases recurrent stroke risk: a 5year nationwide follow-up study" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "P.S. Chou" 1 => "B.L. Ho" 2 => "Y.H. Chan" 3 => "M.H. Wu" 4 => "H.H. Hu" 5 => "A.C. Chao" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/imj.13686" "Revista" => array:5 [ "tituloSerie" => "Intern Med J" "fecha" => "2018" "volumen" => "48" "paginaInicial" => "661" "paginaFinal" => "667" ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib0060" "etiqueta" => "12" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Predictors for atrial fibrillation detection after cryptogenic stroke: results from CRYSTAL AF" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "V.N. Thijs" 1 => "J. Brachmann" 2 => "C.A. Morillo" 3 => "R.S. Passman" 4 => "T. Sanna" 5 => "R.A. Bernstein" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1212/WNL.0000000000002282" "Revista" => array:6 [ "tituloSerie" => "Neurology" "fecha" => "2016" "volumen" => "86" "paginaInicial" => "261" "paginaFinal" => "269" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26683642" "web" => "Medline" ] ] ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib0065" "etiqueta" => "13" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Atrial premature beats predict atrial fibrillation in cryptogenic stroke: results from the EMBRACE trial" "autores" => array:1 [ 0 => array:3 [ "colaboracion" => "EMBRACE Steering Committee and Investigators" "etal" => true "autores" => array:6 [ 0 => "D.J. Gladstone" 1 => "P. Dorian" 2 => "M. Spring" 3 => "V. Panzov" 4 => "M. Mamdani" 5 => "J.S. Healey" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1161/STROKEAHA.115.008714" "Revista" => array:6 [ "tituloSerie" => "Stroke" "fecha" => "2015" "volumen" => "46" "paginaInicial" => "936" "paginaFinal" => "941" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25700289" "web" => "Medline" ] ] ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib0070" "etiqueta" => "14" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Bayés syndrome and acute cardioembolic ischemic stroke" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "A. Arboix" 1 => "L. Martí" 2 => "S. Dorison" 3 => "M.J. Sánchez" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.12998/wjcc.v5.i3.93" "Revista" => array:5 [ "tituloSerie" => "World J Clin Cases" "fecha" => "2017" "volumen" => "16" "paginaInicial" => "93" "paginaFinal" => "101" ] ] ] ] ] ] 14 => array:3 [ "identificador" => "bib0075" "etiqueta" => "15" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Predictors of atrial fibrillation development in patients with embolic stroke of undetermined source: an analysis of the RE-SPECT ESUS Trial" "autores" => array:1 [ 0 => array:3 [ "colaboracion" => "RE-SPECT ESUS Steering Committee and Investigators" "etal" => true "autores" => array:6 [ 0 => "M.C. Bahit" 1 => "R.L. Sacco" 2 => "J.D. Easton" 3 => "J. Meyerhoff" 4 => "L. Cronin" 5 => "E. Kleine" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1161/CIRCULATIONAHA.121.055176" "Revista" => array:5 [ "tituloSerie" => "Circulation" "fecha" => "2021" "volumen" => "30" "paginaInicial" => "1738" "paginaFinal" => "1746" ] ] ] ] ] ] 15 => array:3 [ "identificador" => "bib0080" "etiqueta" => "16" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A clinical score for predicting atrial fibrillation in patients with cryptogenic stroke or transient ischemic attack" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "C. Kwong" 1 => "A.Y. Ling" 2 => "M.H. Crawford" 3 => "S.X. Zhao" 4 => "N.H. Shah" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1159/000476030" "Revista" => array:6 [ "tituloSerie" => "Cardiology" "fecha" => "2017" "volumen" => "138" "paginaInicial" => "133" "paginaFinal" => "140" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28654919" "web" => "Medline" ] ] ] ] ] ] ] ] 16 => array:3 [ "identificador" => "bib0085" "etiqueta" => "17" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Predictors of newly diagnosed atrial fibrillation in cryptogenic stroke: a cohort study" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J.M. Bugnicourt" 1 => "M. Flament" 2 => "M.P. Guillaumont" 3 => "J.M. Chillon" 4 => "C. Leclercq" 5 => "S. Canaple" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/ene.12017" "Revista" => array:6 [ "tituloSerie" => "Eur J Neurol" "fecha" => "2013" "volumen" => "20" "paginaInicial" => "1352" "paginaFinal" => "1359" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23121252" "web" => "Medline" ] ] ] ] ] ] ] ] 17 => array:3 [ "identificador" => "bib0090" "etiqueta" => "18" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Clinical significance of acute and chronic ischaemic lesions in multiple cerebral vascular territories" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "H. Erdur" 1 => "L.S. Milles" 2 => "J.F. Scheitz" 3 => "K. Villringer" 4 => "K.G. Haeusler" 5 => "M. Endres" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s00330-018-5684-8" "Revista" => array:6 [ "tituloSerie" => "Eur Radiol" "fecha" => "2019" "volumen" => "29" "paginaInicial" => "1338" "paginaFinal" => "1347" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30141060" "web" => "Medline" ] ] ] ] ] ] ] ] 18 => array:3 [ "identificador" => "bib0095" "etiqueta" => "19" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Infarct topography and detection of atrial fibrillation in cryptogenic stroke: results from CRYSTAL AF" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "R.A. Bernstein" 1 => "V. Di Lazzaro" 2 => "M.M. Rymer" 3 => "R.S. Passman" 4 => "J. Brachmann" 5 => "C.A. Morillo" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1159/000437018" "Revista" => array:6 [ "tituloSerie" => "Cerebrovasc Dis" "fecha" => "2015" "volumen" => "40" "paginaInicial" => "91" "paginaFinal" => "96" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26182860" "web" => "Medline" ] ] ] ] ] ] ] ] 19 => array:3 [ "identificador" => "bib0100" "etiqueta" => "20" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Predictors of finding occult atrial fibrillation after cryptogenic stroke" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "C.G. Favilla" 1 => "E. Ingala" 2 => "J. Jara" 3 => "E. Fessler" 4 => "B. Cucchiara" 5 => "S.R. Messé" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1161/STROKEAHA.114.007763" "Revista" => array:6 [ "tituloSerie" => "Stroke" "fecha" => "2015" "volumen" => "46" "paginaInicial" => "1210" "paginaFinal" => "1215" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25851771" "web" => "Medline" ] ] ] ] ] ] ] ] 20 => array:3 [ "identificador" => "bib0105" "etiqueta" => "21" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "High pro-BNP levels predict the occurrence of atrial fibrillation after cryptogenic stroke" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "M. Rodríguez-Yáñez" 1 => "S. Arias-Rivas" 2 => "M. Santamaría-Cadavid" 3 => "T. Sobrino" 4 => "J. Castillo" 5 => "M. Blanco" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1212/WNL.0b013e31829d8773" "Revista" => array:6 [ "tituloSerie" => "Neurology" "fecha" => "2013" "volumen" => "81" "paginaInicial" => "444" "paginaFinal" => "447" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23803318" "web" => "Medline" ] ] ] ] ] ] ] ] 21 => array:3 [ "identificador" => "bib0110" "etiqueta" => "22" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Blood biomarkers of heart failure and hypercoagulation to identify atrial fibrillation-related stroke" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M. Kneihsl" 1 => "T. Gattringer" 2 => "E. Bisping" 3 => "D. Scherr" 4 => "R. Raggam" 5 => "H. Mangge" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1161/STROKEAHA.119.025339" "Revista" => array:6 [ "tituloSerie" => "Stroke" "fecha" => "2019" "volumen" => "50" "paginaInicial" => "2223" "paginaFinal" => "2226" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/31216968" "web" => "Medline" ] ] ] ] ] ] ] ] 22 => array:3 [ "identificador" => "bib0115" "etiqueta" => "23" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Progressive gray matter atrophy in lacunar patients with vascular mild cognitive impairment" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "M. Grau-Olivares" 1 => "A. Arboix" 2 => "C. Junqué" 3 => "E.M. Arenaza-Urquijo" 4 => "M. Rovira" 5 => "D. Bartrés-Faz" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1159/000316059" "Revista" => array:6 [ "tituloSerie" => "Cerebrovasc Dis" "fecha" => "2010" "volumen" => "30" "paginaInicial" => "157" "paginaFinal" => "166" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20551631" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/23870206/0000016100000002/v1_202307241700/S2387020623002486/v1_202307241700/en/main.assets" "Apartado" => array:4 [ "identificador" => "43310" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Original articles" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/23870206/0000016100000002/v1_202307241700/S2387020623002486/v1_202307241700/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2387020623002486?idApp=UINPBA00004N" ]
