A Canadian study has found that prolonged remote monitoring increased diagnosis of atrial fibrillation by a factor of five – results which may have profound consequences for people who could suffer an ischemic stroke.

The study found that by monitoring patients at home with a new chest electrode belt for 30 consecutive days, atrial fibrillation was detected in 16 percent of patients. The standard 24-hour monitoring found the arrhythmia in only 3 percent of patients. Detecting atrial fibrillation is a key factor in stroke prevention because it can be effectively treated with certain anti-clotting medications, which can cut the risk of clots and strokes by two-thirds or more.

The findings of the three-year EMBRACE trial represent "an important advance" in determining the cause of up to a third of ischemic strokes, which result from blood clots to the brain, according to Weill Cornell Medical College neurologist Hooman Kamel, M.D. “The results... indicate that prolonged monitoring of heart rhythm should now become part of the standard care of patients with cryptogenic (unexplained) stroke.”

The EMBRACE trial followed 572 patients ages 55 and older with a recent stroke or TIA and in whom standard diagnostic tests (including conventional heart monitoring for at least 24 hours) failed to detect the cause. In practice, stroke patients have traditionally received only short-duration heart monitoring to screen for atrial fibrillation — a strategy that now appears inadequate, according to the study’s findings.

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