CRYPTOGENIC STROKE - COULD LONG TERM CARDIAC MONITORING UNCOVER THE CAUSE


J. Rod Gimbel, M.D., Knoxville, TN, USA

"Cryptogenic Stroke" is defined as an ischemic stroke that is not attributable to a cardioembolic source or large or small vessel disease whose cause remains undetermined after an extensive cardiovascular and hematologic search for the cause. Approximately, 20-25 % of ischemic strokes are "cryptogenic" with some due to unrecognized or undetected atrial fibrillation. The amount of atrial fibrillatory burden is often small and difficult to identify owing to its often asymptomatic, sporadic, and unpredictable occurrence. The most frequent monitoring techniques used to detect atrial fibrillation may not be adequate to determine if unrecognized atrial fibrillation is the underlying cause of a stroke.. Prolonged invasive monitoring may provide better detection. Previous and on-going studies supporting the role of prolonged monitoring will be discussed.