{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,2]],"date-time":"2026-11-02T20:25:31Z","timestamp":1793651131354,"version":"4.5.1"},"reference-count":25,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"8","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[2019,8]]},"abstract":"<jats:sec>\n                    <jats:title>Background and Purpose\u2014<\/jats:title>\n                    <jats:p>Although prolonged cardiac rhythm monitoring (PCM) can reveal a substantial proportion of ischemic stroke (IS) patients with atrial fibrillation not detected by conventional short-term monitoring, current guidelines indicate an uncertain clinical benefit for PCM. We evaluated the impact of PCM on secondary stroke prevention using data from available to date randomized clinical trials and observational studies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods\u2014<\/jats:title>\n                    <jats:p>We performed a comprehensive literature search in MEDLINE, SCOPUS, CENTRAL (Cochrane Central Register of Controlled Trial), and conference proceedings to identify studies reporting stroke recurrence rates in patients with history of cryptogenic IS or transient ischemic attack (TIA) receiving PCM compared with patients receiving conventional (non-PCM) cardiac monitoring.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results\u2014<\/jats:title>\n                    <jats:p>\n                      We included 4 studies (2 randomized clinical trials and 2 observational studies), including a total of 1102 patients (mean age: 68 years, 41% women). We documented an increased incidence of atrial fibrillation detection (risk ratio=2.46; 95% CI, 1.61\u20133.76) and anticoagulant initiation (risk ratio=2.07; 95% CI, 1.36\u20133.17) and decreased risk of recurrent stroke (risk ratio=0.45; 95% CI, 0.21\u20130.97) and recurrent stroke\/TIA (risk ratio=0.49; 95% CI, 0.30\u20130.81) during follow-up for IS\/TIA patients who underwent PCM compared with IS\/TIA patients receiving conventional cardiac monitoring. In the subgroup analysis, according to study type, atrial fibrillation detection, anticoagulant initiation, and IS\/TIA recurrence rates were comparable between PCM and non-PCM in randomized clinical trials and observational studies. No evidence of heterogeneity (\n                      <jats:italic toggle=\"yes\">I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      &lt;12%) was documented across all the aforementioned subgroups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions\u2014<\/jats:title>\n                    <jats:p>We provide preliminary evidence for a potential impact of PCM on secondary stroke prevention, as patients with cryptogenic IS\/TIA undergoing PCM had higher rates of atrial fibrillation detection, anticoagulant initiation, and lower stroke recurrence.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/strokeaha.119.025169","type":"journal-article","created":{"date-parts":[[2019,6,20]],"date-time":"2019-06-20T05:00:46Z","timestamp":1561006846000},"page":"2175-2180","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":68,"title":["Prolonged Cardiac Rhythm Monitoring and Secondary Stroke Prevention in Patients With Cryptogenic Cerebral Ischemia"],"prefix":"10.1161","volume":"50","author":[{"given":"Georgios","family":"Tsivgoulis","sequence":"first","affiliation":[{"name":"From the Second Department of Neurology, Attikon Hospital, School of Medicine, National and Kapodistrian University of Athens, Greece (G.T., A.H.K.)"},{"name":"Department of Neurology, University of Tennessee Health Science Center, Memphis (G.T., A.V.A.)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aristeidis H.","family":"Katsanos","sequence":"additional","affiliation":[{"name":"From the Second Department of Neurology, Attikon Hospital, School of Medicine, National and Kapodistrian University of Athens, Greece (G.T., A.H.K.)"},{"name":"Department of Neurology, University of Ioannina School of Medicine, Greece (A.H.K.)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian","family":"Mac Grory","sequence":"additional","affiliation":[{"name":"Department of Neurology, Alpert Medical School, Brown University, Providence, RI (B.M.G., B.A.R., S.C., K.F., S.Y.)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"K\u00f6hrmann","sequence":"additional","affiliation":[{"name":"Department of Neurology, Universit\u00e4tsklinikum Essen, Germany (M.K.)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brittany A.","family":"Ricci","sequence":"additional","affiliation":[{"name":"Department of Neurology, Alpert Medical School, Brown University, Providence, RI (B.M.G., B.A.R., S.C., K.F., S.Y.)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Konstantinos","family":"Tsioufis","sequence":"additional","affiliation":[{"name":"Department of Neurology, Alpert Medical School, Brown University, Providence, RI (B.M.G., B.A.R., S.C., K.F., S.Y.)"},{"name":"First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, Greece (K.T.)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shawna","family":"Cutting","sequence":"additional","affiliation":[{"name":"Department of Neurology, Alpert Medical School, Brown University, Providence, RI (B.M.G., B.A.R., S.C., K.F., S.Y.)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christos","family":"Krogias","sequence":"additional","affiliation":[{"name":"Department of Neurology, St Josef-Hospital, Ruhr University, Bochum, Germany (C.K.)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter D.","family":"Schellinger","sequence":"additional","affiliation":[{"name":"Departments of Neurology and Neurogeriatry, Johannes Wesling Medical Center, Ruhr University Bochum, Minden, Germany (P.D.S.)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana Rodriguez","family":"Campello","sequence":"additional","affiliation":[{"name":"Stroke Unit, Department of Neurology, Group of Research on Neurovascular diseases, Hospital del Mar Medical Research Institute, DCEX, Universitat Pompeu Fabra, Universitat Aut\u00f2noma de Barcelona, Spain (A.R.C., E.C.-G.)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisa","family":"Cuadrado-Godia","sequence":"additional","affiliation":[{"name":"Stroke Unit, Department of Neurology, Group of Research on Neurovascular diseases, Hospital del Mar Medical Research Institute, DCEX, Universitat Pompeu Fabra, Universitat Aut\u00f2noma de Barcelona, Spain (A.R.C., 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