When routine 7-day ambulatory ECG monitoring should be advocated in patients with ischaemic stroke.

Stroke associated with atrial fibrillation (AF) carries a more unfavourable prognosis, and current screening guidance suggests electrocardiogram (ECG) monitoring for at least 24 hours. It should be noted, however, that 24-hour monitoring in cryptogenic strokes has relatively low rates of AF detection (1.4–6%). Prolonged ECG monitoring can demonstrate that a significant proportion of ‘cryptogenic strokes’ are in fact related to paroxysmal atrial fibrillation (pAF). Our physicians until now advocated the use of 24-hour monitors in all cases of ischaemic stroke and selected cases of TIA. Our aim was to ascertain our current rates of AF detection and to identify where prolonged recording resources should be directed.