Monitoring After Stroke or Transient Ischemic Attack — Don't Forget About Atrial Fibrillation

Atrial fibrillation (AF) is the most common cardiac cause of stroke, and in many patients, the etiology of stroke or transient ischemic attack (TIA) might be undetected paroxysmal AF. To learn how often clinicians search for paroxysmal AF in stroke patients, researchers in Canada examined data from the longitudinal Ontario Stroke Registry on 17,398 consecutive patients in 2003–2013. Patients had a first acute ischemic stroke or TIA and were without known AF (mean age, 69; history of hypertension, 63%; functional independence before the event, 88%). Patients with known cause or poor prognosis were excluded (e.g., those with carotid interventions or palliative care plans).

The index event was stroke in 75% and TIA in 25%. Of the group, 31% und…