Letter by Wachter et al Regarding Article, “Occult Atrial Fibrillation in Cryptogenic Stroke: Detection by 7-Day Electrocardiogram Versus Implantable Cardiac Monitors”

Abstract

To the Editor: We read with great interest the article of Ritter et al,1 which nicely demonstrates that the prolongation of ECG monitoring time increases the detection rate of paroxysmal atrial fibrillation in stroke patients, a result that is in concordance with existing literature. One aspect especially drawn to our attention was the lower yield of the Holter monitoring during simultaneous ECG recording as compared with the implantable loop recorder (ILR). ILRs only store automatically triggered episodes and can detect only atrial fibrillation (AF) episodes of ≥2 minutes, whereas Holter ECGs store (usually semiautomatically analyzed) continuous recordings and …