Minerva Cardiology and Angiology 2022 Jan 26

DOI: 10.23736/S2724-5683.21.05851-8

Copyright © 2021 EDIZIONI MINERVA MEDICA

lingua: Inglese

Atrial fibrillation: focus on monitoring strategies after cryptogenic stroke

Marco G. DEL BUONO ¹, Tommaso SANNA ^{1, 2} ✉

¹ Università Cattolica del Sacro Cuore, Rome, Italy; ² Fondazione Policlinico Gemelli Istituto di Ricerca e Cura a Carattere Scientifico, Rome, Italy

Atrial fibrillation (AF) is responsible for up to one-third of ischemic strokes, with stroke potentially being the first manifestation of a previously undetected AF. Given the efficacy of oral anticoagulants in preventing AF-related ischemic events, searching for unknown AF after stroke requires a comprehensive diagnostic workup. Prospective data have demonstrated the benefits of long‐term cardiac monitoring to identify AF in association with cryptogenic stroke, as most strokes are presumed to result from AF. However, strategies of empirical anticoagulation using oral anticoagulants following cryptogenic stroke failed to improve outcomes. We herein summarize contemporary evidence and knowledge gaps on searching for AF after a stroke and the potential secondary prevention strategies to prevent further recurrences.

KEY WORDS: Atrial fibrillation; Stroke; Monitoring; Review