What is the effectiveness of prolonged cardiac monitoring during hospitalization after AIS to guide treatment selection for prevention of recurrent stroke?
In CRYSTAL AF (Study of Continuous Cardiac Monitoring to Assess Atrial Fibrillation After Cryptogenic Stroke), at 36 months, atrial fibrillation was detected in 30% of 221 patients with implantable cardiac monitors and in 3% of 220 control subjects (P<0.001), but the occurrence of TIA or ischemic stroke was 9% in the implantable cardiac monitor group and 11% in the control group (P=0.64). In Find-AFRANDOMISED (Finding Atrial Fibrillation in Stroke Evaluation of Enhanced and Prolonged Holter Monitoring), atrial fibrillation was detected in 14% of 200 patients with 10-day Holter monitoring at baseline, 3 months, and 6 months versus 5% of 198 patients in the standard care group who had at least 24 hours of rhythm monitoring (P=0.002). The effectiveness of prolonged cardiac monitoring during hospitalization after AIS to guide treatment selection for prevention of recurrent stroke is uncertain.