Atrial fibrillation (AF) is the most common form of cardiac arrhythmias and an independent risk factor for stroke. Despite major
advances in monitoring strategies, clinicians tend to miss the diagnoses of AF and especially paroxysmal AF due mainly to its
asymptomatic presentation and the rather limited duration dedicated for monitoring for AF after a stroke, which is 24 hours as
per the current recommended guidelines. Hence, determining the optimal duration of monitoring for paroxysmal atrial fibrillation
after acute ischemic stroke remains a matter of debate. Multiple trials were published in regard to this matter using both invasive
and noninvasive monitoring strategies for different monitoring periods. The data provided by these trials showcase strong evidence
suggesting a longer monitoring strategy beyond 24 hours is associated with higher detection rates of AF, with the higher percentage
of patients detected consequently receiving proper secondary stroke prevention with anticoagulation and thus justifying the cost-
effectiveness of such measures. Overall, we thus conclude that increasing the monitoring duration for AF after a cryptogenic stroke
to at least 72 hours will indeed enhance the detection rates, but the cost-effectiveness of this monitoring strategy compared to longer