ESOC 2026 | Aims of the ODEA-TIA trial: determining the best approach for detecting AF in TIA

The detection of atrial fibrillation in TIA patients using prolonged cardiac monitoring is crucial for initiating effective secondary prevention using oral anticoagulation. However, the choice of the best duration and monitoring strategy to detect atrial fibrillation is uncertain, as most evidence is taken from mixed-stroke TIA patients at the moment. The ODEA-TIA trial is a multicenter investigator-initiated, randomized, open-label, blinded endpoint assessment trial designed to compare three ECG monitoring strategies for detecting atrial fibrillation in patients aged 50 years or older who experienced a transient ischemic attack within 28 days before randomization and had no prior diagnosis of atrial fibrillation. The participants are randomly assigned in a one-to-one-to-one ratio stratified by center and randomized into three groups. First, a non-invasive 24-hour Holter monitoring. Second, a non-invasive 28-day Holter monitoring. And third, an invasive implantable loop recorder monitoring for 24 months. The primary endpoint is the rate of newly detected atrial fibrillation at 6 months. And secondary endpoints include AF detection at 12 and 24 months and the overall prevalence during the study follow-up of atrial fibrillation. Exploratory analyses include clinical outcomes, initiation of anticoagulation, device adherence and performance parameters and also exploratory analyses of AF burden. There is also a sub-study that investigates the usefulness of blood-based biomarkers, specifically in TIA patients. Overall, ODEA-TIA aims to establish evidence-based cardiac monitoring strategy for detection of atrial fibrillation to improve secondary prevention in TIA patients.

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