Few studies are as striking in their immediate applicability and impact as do the recent randomized controlled trials (RCTs) on prolonged heart rate monitoring in patients with cryptogenic stroke or transient ischemic attack (TIA) [1,2]. They have demonstrated that 30-day monitoring can identify unsuspected paroxysmal atrial fibrillation (AF) in a substantial proportion of patients whose 24-hour ECG was unremarkable. These results confirm that many strokes/TIAs – formerly classified as ‘cryptogenic’ – are in fact cardioembolic and therefore patients should be anticoagulated for secondary prevention, rather than given antiplatelet agents as currently done.
