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Validation of the AF-ESUS score to identify patients with embolic stroke of undetermined source and low risk of device-detected atrial fibrillation

      During the recent years, the term ESUS (embolic stroke of undetermined source) is used to describe patients with ischemic stroke for whom the source of embolism remains undetected despite recommended investigation [
      • Hart R.G.
      • Diener H.C.
      • Coutts S.B.
      • et al.
      Embolic strokes of undetermined source: the case for a new clinical construct.
      ] Although ESUS patients represent a very heterogeneous population in terms of the underlying stroke mechanism, atrial fibrillation (AF) is frequently detected and therefore, prolonged cardiac rhythm monitoring is recommended [
      • Hart R.G.
      • Diener H.C.
      • Coutts S.B.
      • et al.
      Embolic strokes of undetermined source: the case for a new clinical construct.
      ,
      • Ntaios G.
      Embolic stroke of undetermined source: JACC review topic of the week.
      ,
      • Ntaios G.
      • Perlepe K.
      • Lambrou D.
      • et al.
      Prevalence and overlap of potential embolic sources in patients with embolic stroke of undetermined source.
      ] However, only a minority of ESUS patients receive prolonged cardiac monitoring, mainly due to limited availability of technical and human resources, and the considerable cost of some of the available monitoring options [
      • Schnabel R.B.
      • Haeusler K.G.
      • Healey J.S.
      • et al.
      Searching for atrial fibrillation poststroke: a white paper of the AF-SCREEN international collaboration.
      ]. Therefore, tools to identify better candidates for prolonged cardiac monitoring are welcome, as they could increase the diagnostic yield [
      • Schnabel R.B.
      • Haeusler K.G.
      • Healey J.S.
      • et al.
      Searching for atrial fibrillation poststroke: a white paper of the AF-SCREEN international collaboration.
      ].

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      References

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        Embolic strokes of undetermined source: the case for a new clinical construct.
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        Searching for atrial fibrillation poststroke: a white paper of the AF-SCREEN international collaboration.
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