The current state of care delivery in cardiac rhythm monitoring after ischemic stroke

Ischemic stroke is one of the leading causes of disability and mortality worldwide. Strokes resulting from atrial fibrillation (AF) are often more severe and are associated with higher recurrence rates. When AF is detected after stroke, oral anticoagulation (OAC) is usually initiated, as this potentially reduces the risk of recurrence. Several studies have shown that prolonged cardiac rhythm monitoring increases the detection rate of previously undiagnosed AF; a meta-analysis describes an approximately threefold increase in detection probability (1). To date, there are no standardized recommendations regarding the optimal duration and method of prolonged cardiac rhythm monitoring. The European Stroke Organization (ESO) guidelines recommend cardiac rhythm monitoring for > 48 hours in patients with stroke of unknown cause (2). The objectives of this subanalysis of the Find-AF 2 study data were to describe the actual practice of outpatient cardiac rhythm monitoring during the first year after ischemic stroke in Germany and to compare it with the recommendations of the treating hospitals.