{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T06:09:25Z","timestamp":1788847765273,"version":"build-2803163510"},"reference-count":144,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2022,6,8]],"date-time":"2022-06-08T00:00:00Z","timestamp":1654646400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,10,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>The role of subclinical atrial fibrillation as a cause of cryptogenic stroke is unambiguously established. Long-term electrocardiogram (ECG) monitoring remains the sole method for determining its presence following a negative initial workup. This position paper of the European Society of Cardiology Working Group on e-Cardiology first presents the definition, epidemiology, and clinical impact of cryptogenic ischaemic stroke, as well as its aetiopathogenic association with occult atrial fibrillation. Then, classification methods for ischaemic stroke will be discussed, along with their value in providing meaningful guidance for further diagnostic efforts, given disappointing findings of studies based on the embolic stroke of unknown significance construct. Patient selection criteria for long-term ECG monitoring, crucial for determining pre-test probability of subclinical atrial fibrillation, will also be discussed. Subsequently, the two major classes of long-term ECG monitoring tools (non-invasive and invasive) will be presented, with a discussion of each method\u2019s pitfalls and related algorithms to improve diagnostic yield and accuracy. Although novel mobile health (mHealth) devices, including smartphones and smartwatches, have dramatically increased atrial fibrillation detection post ischaemic stroke, the latest evidence appears to favour implantable cardiac monitors as the modality of choice; however, the answer to whether they should constitute the initial diagnostic choice for all cryptogenic stroke patients remains elusive. Finally, institutional and organizational issues, such as reimbursement, responsibility for patient management, data ownership, and handling will be briefly touched upon, despite the fact that guidance remains scarce and widespread clinical application and experience are the most likely sources for definite answers.<\/jats:p>","DOI":"10.1093\/ehjdh\/ztac026","type":"journal-article","created":{"date-parts":[[2022,6,8]],"date-time":"2022-06-08T13:31:31Z","timestamp":1654695091000},"page":"341-358","source":"Crossref","is-referenced-by-count":33,"title":["ESC Working Group on e-Cardiology Position Paper: accuracy and reliability of electrocardiogram monitoring in the detection of atrial fibrillation in cryptogenic stroke patients"],"prefix":"10.1093","volume":"3","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0399-4111","authenticated-orcid":false,"given":"Polychronis E","family":"Dilaveris","sequence":"first","affiliation":[{"name":"First Department of Cardiology, Hippokration Hospital, National and Kapodistrian University of Athens , 114 Vas. Sofias Avenue, 11527 Athens ,","place":["Greece"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4861-2404","authenticated-orcid":false,"given":"Christos Konstantinos","family":"Antoniou","sequence":"additional","affiliation":[{"name":"First Department of Cardiology, Hippokration Hospital, National and Kapodistrian University of Athens , 114 Vas. Sofias Avenue, 11527 Athens ,","place":["Greece"]},{"name":"Electrophysiology and Pacing Laboratory, Athens Heart Centre, Athens Medical Center, Marousi , Attica ,","place":["Greece"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enrico G","family":"Caiani","sequence":"additional","affiliation":[{"name":"Politecnico di Milano, Department of Electronics, Information and Biomedical Engineering , Milan ,","place":["Italy"]},{"name":"National Council of Research, Institute of Electronics, Information and Telecommunication Engineering , Milan ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruben","family":"Casado-Arroyo","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Erasme Hospital, Universit\u00e9 Libre de Bruxelles , Brussels ,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreu \u039c","family":"Climent","sequence":"additional","affiliation":[{"name":"ITACA Institute, Universitat Polit\u00e8cnica de Val\u00e8ncia, Camino de Vera s\/n , Valencia ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthijs","family":"Cluitmans","sequence":"additional","affiliation":[{"name":"CARIM School for Cardiovascular Diseases, Maastricht University Medical Center , Maastricht ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin R","family":"Cowie","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Royal Brompton Hospital , London ,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wolfram","family":"Doehner","sequence":"additional","affiliation":[{"name":"Berlin Institute of Health at Charit\u00e9\u2014Universit\u00e4tsmedizin Berlin, BIH Center for Regenerative Therapies (BCRT) , Charit\u00e9platz 1, 10117 Berlin ,","place":["Germany"]},{"name":"Department of Cardiology (Virchow Klinikum), and Center for Stroke Research Berlin, Charit\u00e9 Universit\u00e4tsmedizin Berlin, and German Centre for Cardiovascular Research (DZHK) , partner site Berlin ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5394-1312","authenticated-orcid":false,"given":"Federico","family":"Guerra","sequence":"additional","affiliation":[{"name":"Cardiology and Arrhythmology Clinic, Marche Polytechnic University, University Hospital \u2018Ospedali Riuniti Umberto I\u2014Lancisi\u2014Salesi\u2019 , Ancona ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Magnus T","family":"Jensen","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Copenhagen University Hospital Amager & Hvidovre ,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zbigniew","family":"Kalarus","sequence":"additional","affiliation":[{"name":"DMS in Zabrze, Department of Cardiology, Medical 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