Background/Aims
The use of an external telemetry device (ETD) to detect paroxysmal atrial fibrillation (pAF) is a key investigation following an Embolic Stroke of Unknown Source (ESUS). However, not all ESUS patients are fitted with an ETD. Effectively operating an ETD requires both physical capacity and technological literacy. This study aims to investigate differences in the rate of ETD use amongst patients of differing ages, National Institutes of Health Stroke Scale (NIHSS) scores, and culturally and linguistically diverse (CALD) backgrounds.
Method
This was a single centre, retrospective study of inpatients at a comprehensive stroke centre with confirmed ESUS between January 2023 and December 2024. Data were analysed using descriptive statistics and inferential testing as appropriate.
Results
229/621 (37%) ischaemic stroke patients met diagnostic criteria for ESUS. Of these, 95/229 (41%) were fitted with an EDT. A total of 21 patients identified as CALD. The median age of patients fitted with an ETD was significantly lower than those not fitted with an ETD (63 vs 75, p<0.01). The NIHSS scores were significantly lower in patients fitted with an ETD, compared to those who were not (2 vs 3.5, p<0.01). CALD patients were significantly less likely to receive an ETD compared to non-CALD patients (10% vs 45%, p<0.01).
Conclusion
Older patients, CALD patients and those with higher NIHSS are less likely to receive ETDs. This may have implications for detection of pAF in these populations. Further efforts are required to characterise the barriers to ETDs and improve accessibility.