Detection of Atrial Fibrillation in Ischemic Stroke Patients: A Systematic Review and Meta-Analysis of Secondary Stroke Prevention

Abstract

Evidence of atrial fibrillation (AF) is often sought in patients with ischemic stroke or transient ischemic attack (TIA), and confers a high risk of recurrent stroke. Guidelines for detection of AF following stroke vary. Therefore, we aimed to determine the frequency of newly detected AF by ambulatory cardiac monitoring through a systematic review and metaanalysis of the literature. We found a higher rate of AF detection by three modes of ambulatory cardiac monitoring – mobile cardiac outpatient telemetry, external loop reordering, and internal loop recording – when compared with rates of newly detected AF in inpatient bedside monitoring techniques. We suggest a systematic approach that can be applied clinically to increase rates of AF detection, thus allowing for increased secondary stroke prevention through the use of anticoagulants.