Prolonged ambulatory cardiac monitoring after a cryptogenic ischemic stroke or transient ischemic attack appears to be a more effective method for detecting occult atrial fibrillation than standard methods.
In the largest randomized trial to evaluate whether longer ECG monitoring is beneficial after stroke, researchers for the EMBRACE trial assigned patients to wear an event-triggered cardiac monitor for up to 30 days or a repeat 24-hour Holter monitor to record AF events. The trial included 572 patients (mean age, 73 years) who had a recent cryptogenic ischemic stroke (63%) or TIA (37%) and no known AF after standard diagnostic interventions that included a negative Holter monitor.
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