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Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia and is associated with a five-fold increased risk of stroke. At least 15-20% of strokes are attributed to underlying AF, but subclinical AF may be the cause of an additional number of cerebrovascular events. Data from cardiac implantable electronic devices (CIEDs) have shown that subclinical atrial tachyarrhythmias lasting more than six minutes are associated with increased risk of thromboembolism.1 The often silent and intermittent nature of AF poses a problem; more than half of AF episodes are asymptomatic2,3 and therefore identifying patients at risk remains a challenge. This is a good illustration of the importance of AF monitoring. Continuous monitoring with implantable cardiac monitors is now widely used in patients with cryptogenic stroke to identify those with silent AF who warrant antithrombotic therapy.4 In this context, the prevalence of AF is approximately 20%. Stroke guidelines state that prolonged rhythm monitoring for AF of approximately 30 days is reasonable within six months of a cerebrovascular event with no apparent cause.5 In addition to risk stratification for stroke prevention, AF monitoring and detection is also useful to assess the efficacy

Atrial fibrillation monitoring to reduce thromboembolic risk: Selecting the patient and the monitoring device