Recurrent cryptogenic stroke: A potential role for an artificial intelligence–enabled electrocardiogram?
Anthony H. Kashou, Alejandro A. Rabinstein, Itzhak Zachi Attia, Samuel J. Asirvatham, Bernard J. Gersh, Paul A. Friedman, Peter A. Noseworthy
Abstract
Approximately 20% of all ischemic strokes are cryptogenic—they have an uncertain cause despite thorough diagnostic evaluation.1 Many such patients undergo long-term cardiac monitoring for detection of atrial fibrillation (AF), but in the absence of clearly documented AF, there is controversy regarding the best approach to secondary prevention.2 While anticoagulation may seem reasonable for some patients, empiric anticoagulation has not been shown to prevent recurrent events and may not outweigh the risk of bleeding in patients with embolic stroke of unknown source (ie, cryptogenic strokes with embolic pattern on brain imaging but no documented embolic source).