To Screen or Not for AF: Is That the Question?

Two studies suggest longer-duration monitoring for AF is needed after apparently cryptogenic stroke, but many questions remain.

Up to one third of ischemic strokes are of uncertain etiology or “cryptogenic,” meaning that there is no overt explanation such as severe carotid stenosis, intracranial stenosis, or documented atrial fibrillation (AF). For some of these patients, intermittent AF may be present and could explain the ischemic stroke. This issue has been addressed by two recent studies.

In the EMBRACE study, researchers randomized 572 patients aged 55 or older with cryptogenic stroke to either 30-day electrocardiogram (ECG) monitoring with a portable event monitor or to a standard 24-hour ECG recording. The primary outcome was newly detected AF lasting 30 seconds or more within 90 days of study entry. This endpoint was detected in 16.1% of the prolonged monitor…

Reviewing Author

Seemant Chaturvedi, MD

Disclosures

Consultant/Advisory BoardBayer Pharmaceuticals; Novartis

Grant/Research SupportNational Institute of Neurological Disorders and Stroke

Editorial BoardsNeurology; Stroke

Seemant Chaturvedi, MD

Disclosures

Consultant/Advisory BoardBayer Pharmaceuticals; Novartis

Grant/Research SupportNational Institute of Neurological Disorders and Stroke

Editorial BoardsNeurology; Stroke

To Screen or Not for AF: Is That the Question?

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Reviewing Author