Thomas Meinel, MD, Bern University Hospital, and University of Bern, Bern, Switzerland, examines the growing discussion surrounding the detection of atrial fibrillation (AF) after a stroke and the concept of atrial fibrillation detected after stroke (AFDAS). There has been growing debate regarding whether known AF is different to AFDAS with regards to their clinical relevance. Dr Meinel points out that the burden of AF may be more important than the time of detection. For example, if AF is detected on a 12-channel electrocardiogram (ECG) or on a stroke unit after 72 hrs ECG monitoring then this would likely be an indication for anticoagulation. However, if a patient has an implantable loop recorder and shows minimal AF after long term recording, it should be questioned whether this merits anticoagulation. This interview took place during the European Stroke Organisation Conference (ESOC) in Munich, Germany.
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