A commentary notes that the overall message of this research is not new but deserves to be reinforced. More prolonged monitoring detects more clinically important AF which is more likely to have direct therapeutic implications for patients. AF is a sporadic event and so duration of monitoring affects detection rate, probably more than does the method of monitoring. However, at least three key questions remain regarding cardiac monitoring for atrial fibrillation after stroke or TIA: what is the best time and duration of the chosen monitoring method or methods? which patients are most likely to benefit from prolonged cardiac monitoring, by either a single method or a combination of methods? and what is the prognostic value of very brief episodes of atrial fibrillation identified by these methods?
The commentators suggest that irrespective of the cardiac monitoring method used, robust and validated clinical predictors of AF in patients with stroke or TIA could help to direct screening towards high-risk patients and perhaps even allow presumptive early secondary prevention while awaiting confirmatory detection of the culprit arrhythmia.