{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T13:43:39Z","timestamp":1792417419857,"version":"4.4.0"},"reference-count":20,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","license":[{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Objectives:<\/jats:title>\n                    <jats:p>Cryptogenic stroke (CS) accounts for a significant percentage of ischemic strokes. Undetected atrial fibrillation (AF) is a major underlying cause, and delayed identification increases recurrence risk. This study evaluated the timing of AF detection after CS and its impact on stroke recurrence and secondary prevention in a tertiary care setting.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This retrospective observational analysis comprised 355 adult patients with CS hospitalized from January 2020 to June 2024. Demographic data, AF detection, timing, monitoring options, anticoagulation status, and stroke recurrence were all recorded. A multivariable Cox regression analysis identified predictors of recurrent stroke. SPSS version 23.0 was used for analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Among 355 CS patients, 115 (32.4%) were diagnosed with AF during the follow-up period. The median time to AF detection was 5.5 months. Modalities for detection included Holter monitoring 55 (47.8%), electrocardiography 48 (41.7%), and implantable loop recorders 12 (10.4%). Among those with AF, 34 (29.6%) suffered a recurrent stroke; only 12 (35.3%) were on anticoagulation at the time of recurrence. Independent predictors of recurrence included age &gt;65 years (hazard ratio [HR] 2.29;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.012), delayed AF diagnosis &gt;6 months (HR 2.51;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.003), non-adherence to anticoagulation (HR 3.59,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.002), and left atrial enlargement (HR 2.31,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.017).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Delayed AF diagnosis in CS is prevalent and has been linked to a significantly greater risk of recurrent stroke. Early and extended cardiac monitoring, combined with early anticoagulation, is critical for improving patient outcomes in CS.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/aian.aian_1337_25","type":"journal-article","created":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T05:00:08Z","timestamp":1780290008000},"page":"380-385","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Delayed Detection of Atrial Fibrillation After Cryptogenic Stroke and Risk of Recurrent Ischemic Stroke: A Retrospective Cohort Study"],"prefix":"10.4103","volume":"29","author":[{"given":"Sadiq A","family":"Shah","sequence":"first","affiliation":[{"name":"Department of Neurology, Lady Reading Hospital, Peshawar, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taimoor","family":"Khan","sequence":"additional","affiliation":[{"name":"Department of Neurology, Lady Reading Hospital, Peshawar, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khadija","family":"Syed","sequence":"additional","affiliation":[{"name":"Department of Medicine, Hayat Abad Medical Complex, Peshawar, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Safi","family":"Ullah","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Peshawar Institute of Cardiology, Peshawar, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad","family":"Bilal","sequence":"additional","affiliation":[{"name":"Department of Medicine, Hayat Abad Medical Complex, Peshawar, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,5,29]]},"reference":[{"key":"R1-20261019","doi-asserted-by":"crossref","first-page":"867","DOI":"10.1161\/STROKEAHA.116.016414","article-title":"Embolic stroke of undetermined source: A systematic review and clinical 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