AIRSAF-STROKE Study

AI-ECG Risk Stratification and Loop Recorder Monitoring to Detect Atrial Fibrillation in STROKE Patients (Short: AIRSAF-STROKE)

AIRSAF-STROKE invites patients, who have experienced a stroke, to contribute to research that aims to better understand the role of atrial fibrillation (AF) in the risk of recurrent stroke. The study is an observational clinical research sub-study within the IHI-funded UMBRELLA registry and is part of the broader AF-B-STEP initiative.

AF is a common heart rhythm disorder that can significantly increase the risk of stroke, particularly when it remains undetected.

The main goal is to better understand how different patterns and amounts of atrial fibrillation (so-called “AF burden”), measured through continuous implantable cardiac monitoring (ICM), are linked to the risk of recurrent stroke.

To achieve this, a real-world observational dataset will be created that ensures a balanced representation of post-stroke patients across the full spectrum of AF burden. This may help improve future methods for identifying patients at higher risk and tailoring prevention strategies more precisely.

The study will also:

  • Estimate an AF burden threshold that helps distinguish patients with higher versus lower risk of recurrent stroke, to inform future clinical trials
  • Analyse current clinical practice regarding the initiation of blood-thinning treatment after stroke
  • Evaluate how well artificial intelligence-based electrocardiogram predictions of AF burden correspond with actual ICM-measured AF burden
  • Assess the time to first detected AF episode depending on AI-predicted risk level
  • Analyse the cost-effectiveness of combining AI-based electrocardiogram (ECG) screening with implantable monitoring strategies

All participants will receive continuous heart rhythm monitoring using an implantable cardiac monitoring device for up to 24 months after stroke. This allows for the detection of both known and previously undiagnosed AF.

Potentially eligible individuals will be identified and contacted through the UMBRELLA sites.


Study concept: 24-month implantable cardiac monitoring after a STROKE to quantify AF burden, validate AI-based ECG predictions, and refine recurrent stroke risk stratification.

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