![]() complex aortic atheroma or plaque on imaging.Previous stroke or transient ischaemic attack or history of systemic thromboembolism Hypertension – whether or not blood pressure is currently elevated ![]() moderately–severely reduced left ventricular function in the absence of previous symptoms.Also, we need more data to establish the burden of atrial fibrillation detected by these devices before starting therapy. 14, 15 However, more research is needed before the routine use of these tools. 11-13 We may soon have eHealth tools like smartphone ECG devices which might contribute to higher detection rates of silent atrial fibrillation. This follows clear demonstrable benefits to increased quality-adjusted life-years and a reduced incidence of stroke. Opportunistic screening (pulse check and ECG) of all patients over the age of 65 years in general practice is now strongly recommended by international guidelines. Monitoring by implanted loop recorders may be a better monitoring strategy especially for candidates with recurrent transient ischaemic attacks and cryptogenic stroke. 9 Hence all patients with ischaemic stroke should be screened either by a 12-lead ECG or preferably by a 24-hour Holter recording. Silent atrial fibrillation is present in around 10% of patients who have an ischaemic stroke.
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