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Detection of Atrial Fibrillation and Secondary Stroke Prevention Using Telemetry and Ambulatory Cardiac Monitoring

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Abstract

Identifying atrial fibrillation (AF) as the cause of stroke is important because it may trigger a change from therapy with antiplatelet agents to proven superior therapy with anticoagulants. Ischemic stroke due to chronic AF is readily diagnosed, but if patients with intermittent AF remain in sinus rhythm throughout their hospitalization, they will likely be discharged on inferior treatment. Numerous monitoring techniques can identify intermittent AF, and the available evidence suggests that prolonging the duration of monitoring increases the likelihood of detecting AF, which supports the use of monitoring beyond the currently recommended 24 h. Further research is required to definitively establish the utility of cardiac monitoring and identify the optimum method and duration. The promise of new drugs to replace warfarin in the near future reinforces the importance of this line of research. Even using current therapeutics, optimizing the diagnosis of AF remains a key component of quality care for patients with ischemic stroke.

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Disclosure

Hooman Kamel reports no potential conflict of interest relevant to this article. Wade S. Smith has worked as a consultant for Medtronic in the past and is currently working as a paid consultant for and has equity in Concentric Medical.

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Authors and Affiliations

  1. Department of Neurology, University of California, San Francisco, USA

    Hooman Kamel & Wade S. Smith

  2. 505 Parnassus Ave, Box 0114, San Francisco, CA, 94143, USA

    Hooman Kamel

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  1. Hooman Kamel
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Correspondence to Hooman Kamel.

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Kamel, H., Smith, W.S. Detection of Atrial Fibrillation and Secondary Stroke Prevention Using Telemetry and Ambulatory Cardiac Monitoring. Curr Atheroscler Rep 13, 338–343 (2011). https://doi.org/10.1007/s11883-011-0180-5

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