PMID- 22562457
OWN - NLM
STAT- PubMed-not-MEDLINE
DCOM- 20121002
LR  - 20211021
IS  - 1534-3189 (Electronic)
IS  - 1092-8464 (Linking)
VI  - 14
IP  - 3
DP  - 2012 Jun
TI  - Detection of atrial fibrillation after cryptogenic stroke.
PG  - 298-304
LID - 10.1007/s11936-012-0180-y [doi]
AB  - Patients with ischemic stroke and atrial fibrillation (AF) are treated with 
      long-term oral anticoagulation (OAC) because it is considerably more effective 
      than antiplatelet (AP) therapy for the prevention of subsequent strokes and 
      systemic emboli. Therefore, detecting AF changes therapy and makes secondary 
      prevention more effective. Technology for detection of rare episodes of 
      paroxysmal AF (PAF) has improved recently. AF that is only detectable by 
      prolonged monitoring (occult AF, or oAF) may underlie some strokes of unknown 
      cause (cryptogenic stroke). However, the ideal method and duration of cardiac 
      monitoring to detect oAF after stroke is unknown. Furthermore, new technologies 
      allow the detection of brief, rare episodes of AF that would not have been 
      detectable at the time classic studies establishing the benefit of OAC were 
      conducted. Therefore, it is unknown what the minimum threshold of oAF burden or 
      duration is that mandates OAC instead of AP therapy. Here we review the available 
      technologies, and discuss the therapeutic implications and uncertainties when oAF 
      is found after ischemic stroke. There is evidence that 3 weeks of outpatient 
      cardiac telemetry has a high yield of detection of AF after cryptogenic stroke; 
      however, ongoing studies may show that even longer monitoring periods have higher 
      yield.
FAU - Bernstein, Richard A
AU  - Bernstein RA
AD  - Department of Neurology, Feinberg School of Medicine of Northwestern University, 
      710 North Lake Shore Drive, Abbott Hall 11th Floor, Chicago, IL, 60611, USA, 
      r-bernstein@northwestern.edu.
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Curr Treat Options Cardiovasc Med
JT  - Current treatment options in cardiovascular medicine
JID - 9815942
EDAT- 2012/05/09 06:00
MHDA- 2012/05/09 06:01
CRDT- 2012/05/08 06:00
PHST- 2012/05/08 06:00 [entrez]
PHST- 2012/05/09 06:00 [pubmed]
PHST- 2012/05/09 06:01 [medline]
AID - 10.1007/s11936-012-0180-y [doi]
PST - ppublish
SO  - Curr Treat Options Cardiovasc Med. 2012 Jun;14(3):298-304. doi: 
      10.1007/s11936-012-0180-y.