Detection of paroxysmal atrial fibrillation by prolonged electrocardiographic recording after ischaemic stroke in patients aged < 60 years: A study with 21-day recording using the SpiderFlash ® monitor

Summary Background Many studies have suggested that longer duration of cardiac monitoring is suitable for the detection of occult paroxysmal atrial fibrillation (AF) after stroke; however, most studies involved patients aged ≥ 65 years – a population with a high stroke rate. Aims To assess the incidence of paroxysmal AF in unselected young patients presenting with stroke. Methods We included consecutive patients aged  ® monitor for 21 days after discharge from hospital. The primary outcome was detection of paroxysmal AF episodes lasting > 30 seconds during monitoring. The secondary outcome was detection of paroxysmal AF episodes lasting  Results Among the 56 patients included (mean age 48 ± 9 years), 39 had cryptogenic stroke (CS) and 17 had stroke of known cause (SKC). Cardiac monitoring was achieved in 54 patients (37 CS, 17 SKC); one CS patient had a paroxysmal AF episode lasting > 30 seconds and one CS patient had a paroxysmal AF episode lasting  Conclusion This prospective observational study showed a low rate of paroxysmal AF among young patients presenting with stroke, on the basis of 21-day cardiac monitoring. This result highlights the need to identify patients who would benefit from such long monitoring.