Longer duration of electrocardiographic monitoring after cryptogenic stroke is associated with a greater detection of AF .
BACKGROUND Atrial fibrillation ( AF ) is a major cause of stroke .
Although st and ard investigations after an event include electrocardiographic monitoring , the optimal duration to detect AF is unclear .
We performed a systematic review and meta- analysis to determine whether the duration of electrocardiographic monitoring after an ischemic event is related to the detection of AF .
Paroxysmal atrial fibrillation in cryptogenic stroke: a case-control study.
BACKGROUND It is unclear if brief episodes of paroxysmal atrial fibrillation ( PAF ) detected by prolonged cardiac monitoring are an occult of cause of cryptogenic strokes ( CS ) . We compared the incidence of PAF in patients with CS and patients with stroke of known cause ( SKC ) using prolonged ambulatory cardiac monitoring . METHODS We prospect ively enrolled patients within 3 months of ischemic stroke to undergo noninvasive cardiac monitoring for 3 weeks . Primary end point was PAF detection independently confirmed by 2 blinded cardiologists . RESULTS The study consisted of 132 patients , 66 had CS and 66 had SKC .  Episodes of PAF were detected in 16 of 64 ( 25 % ) patients with CS and 9 of 64 ( 14 % ) patients with SKC ( P=.12 ) . Duration and number of PAF episodes , PAF burden , and time of first PAF detection did not differ significantly between the 2 groups ( P>.05 for all ) . In patients younger than 65 years , PAF was more common in the CS group ( 22 % versus 3 % ; P=.07 ) , whereas in patients 65 years or older , the rates of detection were similar ( 27 % in CS versus 25 % in SKC ; P=.9 ) . Among patients younger than 65 years with embolic imaging pattern , PAF was only observed in the CS group ( 21 % versus 0 % ; P=.03 ) . CONCLUSIONS Very short episodes of PAF are common in patients with CS and with SKC , but their pathogenic significance is unclear . Predominance of PAF in younger patients with CS and embolic infa rct pattern suggests a causative role in these cases . More research is needed before prolonged cardiac rhythm monitoring can be recommended to guide anticoagulation in CS patients
Longer duration of electrocardiographic monitoring after cryptogenic stroke is associated with a greater detection of AF .
BACKGROUND Atrial fibrillation ( AF ) is a major cause of stroke .
Although st and ard investigations after an event include electrocardiographic monitoring , the optimal duration to detect AF is unclear .
We performed a systematic review and meta- analysis to determine whether the duration of electrocardiographic monitoring after an ischemic event is related to the detection of AF .