Abstract Body: Introduction
Continuous electrocardiographic monitoring using an implantable loop recorder (ILR) can facilitate the detection of asymptomatic atrial fibrillation episodes. At our institution, ILRs are monitored by cardiology but treated by neurology when inserted after an ischemic stroke. When loop monitors showed positive results, we identified a break in communication between cardiology and neurology. We investigated whether the nurse navigator (NN) can bridge the gap in delayed communication between neurology, cardiology, and atrial fibrillation treatment.

Methods
Using a prospectively maintained Comprehensive Stroke Center database, we reviewed our ischemic stroke patients with implantable loop recorders from January 2024 to July 2024. After insertion the NN logs the patient into the database and tracks the patient’s monthly interrogation report. When positive, the neurology provider who last saw the patient is notified via a priority message in the EMR. The NN continues to track the patient until the neurologist initiates a treatment plan. Variables include the type of device, time from admission to loop insertion, and patient compliance with monitoring.

Results
From Jan 2024- July 2024, 62 individuals were implanted with a loop recorder. 7 patients had Biotronik ICM loop recorders, 13 had Boston Scientific Lux loop recorders, 35 had Medtronic Lux loop recorders, and 7 had Mobile Cardiac Outpatient Telemetry Devices (MCOT). The median time from implantation to the first detected atrial fibrillation was 115.7 days. The total positive detection of atrial fibrillation was 12 cases. The total number of patients who had detected atrial fibrillation in less than 30 days was 2.

Conclusion
The comprehensive role of the nurse is pivotal in ensuring the successful integration of ILRs into patient care, from preparation for implantation to post-operative follow-up and data interpretation. The NN collaborates closely with the healthcare team to analyze data retrieved from ILRs, facilitating timely and accurate diagnoses. After implementing this program, the NN identified and ensured treatment was started for 12 out of 62 patients who tested positive for atrial fibrillation between Jan 2024 and June 2024. In doing so, the NNimproves patient outcomes, enhances the overall efficacy of loop recorder use in clinical practice, and ensures the timely treatment of positive atrial fibrillation findings.