Atrial CMR in patients with CVA of unknown source and no known AF

  • Research type

    Research Study

  • Full title

    Atrial Cardiac Magnetic Resonance Imaging in Patients with Embolic Stroke of Unknown Source without Documented Atrial Fibrillation

  • IRAS ID

    269654

  • Contact name

    Steven Williams

  • Contact email

    steve.williams@kcl.ac.uk

  • Sponsor organisation

    King's College London

  • Duration of Study in the UK

    3 years, 0 months, 0 days

  • Research summary

    This research will investigate a new method for identifying which patients should be offered blood thinners or therapies to reverse the underlying causes after stroke.

    An irregular heart beat (atrial fibrillation; AF) is the primary risk factor for ischaemic stroke, increasing the risk by up to 5-fold. In AF, the upper heart chambers don't pump blood effectively into the lower chambers. When this happens, a blood clot can form, dislodge and leave the heart blocking an artery in the brain and cause a stroke. However, AF is often an intermittent condition and therefore difficult to diagnose. As such, there are a group of patients in whom no cause of their stroke can be identified.

    In this study, we will recruit 92 patients from Guy's and St Thomas' Hospital, Princess Royal University Hospital and King's College London. As part of routine clinical care, patients undergo insertion of an Implantable Loop Recorder (CE Marked device), a minimally invasive procedure that allows accurate beat-to-beat monitoring to identify patients who develop intermittent AF post-stroke. We will request access to the data collected from this device and perform atrial MRI imaging in these patients to compare the findings between patients that do and do not have AF. If we show that atrial MRI scans are significantly different between patients with and without AF, we will use this information to support a trial of starting appropriate therapies (e.g. blood thinners) in these patients on the basis of MRI findings. This approach would have the advantage of enabling therapies to be offered to the right patients earlier and prevent repeat, potentially disabling stroke.

  • REC name

    London - South East Research Ethics Committee

  • REC reference

    19/LO/1933

  • Date of REC Opinion

    6 Mar 2020

  • REC opinion

    Further Information Favourable Opinion