Detection of Atrial Fibrillation in Cryptogenic Stroke

  • Karl Georg HaeuslerEmail author
  • Serdar Tütüncü
  • Renate B. Schnabel
Stroke (H Diener, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Stroke


Purpose of Review

To summarize the literature on the detection of atrial fibrillation (AF) in patients with “cryptogenic” stroke, a cohort including about 25% of all ischemic stroke patients and patients with embolic stroke of undetermined source (ESUS).

Recent Findings

A first episode of AF is detected in up to one third of cryptogenic stroke and in up to one fourth of ESUS patients during long-term monitoring. AF prevalence correlates to patient selection, duration, and quality of ECG monitoring. Higher rates of AF were reported in stroke patients with left atrial pathology, specific ECG alterations, or increased natriuretic peptides. While AF detection impacts on medical stroke prevention in the vast majority of patients, patient selection for prolonged monitoring is largely left at the physician’s discretion.


AF detection after cryptogenic stroke or ESUS is a frequent, potentially causal condition. Whether subsequent oral anticoagulation may improve outcome remains open.


Ischemic stroke Atrial fibrillation ECG monitoring Stroke unit Cryptogenic stroke Embolic stroke of undetermined source 


Compliance with Ethical Standards

Conflict of Interest

Karl Georg Haeusler has received grants and personal fees from Bayer and Sanofi, personal fees from Boehringer Ingelheim, Daiichi-Sankyo, Pfizer, BMS, Medtronic, EIP Pharma, Edwards Lifesciences, and non-financial support from Getemed.

Serdar Tütüncü has received lecture fees from DTN-Kompakt (meeting/conference).

Renate B. Schnabel has received a grant from the European Research Council, and personal fees from BMS/Pfizer and the German Cardiac Society.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Karl Georg Haeusler
    • 1
    • 2
    • 3
    • 4
    Email author
  • Serdar Tütüncü
    • 2
  • Renate B. Schnabel
    • 3
    • 5
    • 6
  1. 1.Department of NeurologyCharité – Universitätsmedizin BerlinBerlinGermany
  2. 2.Center for Stroke Research BerlinCharité – Universitätsmedizin BerlinBerlinGermany
  3. 3.Atrial Fibrillation NETwork (AFNET) e.VMünsterGermany
  4. 4.Department of Neurology, Universitätsklinikum WürzburgWürzburgGermany
  5. 5.Abteilung für Allgemeine und Interventionelle KardiologieUniversitäres Herzzentrum HamburgHamburgGermany
  6. 6.Deutsches Zentrum für Herz-Kreislauf-Forschung e.V. (DZHK)Partner Site Hamburg/Kiel/LübeckLübeckGermany

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