Journal of the American College of Cardiology (JACC)ACC Issues Guidance on Arrhythmia Monitoring After Stroke

The American College of Cardiology’s 2024 Expert Consensus Decision Pathway offers structured guidance on arrhythmia monitoring following stroke, addressing a critical gap in post-stroke care management. This comprehensive framework provides clinicians with specific strategies for implementing cardiac monitoring protocols, selecting appropriate monitoring devices, and establishing collaborative care approaches to enhance arrhythmia detection and management in stroke patients.

Key Points:

• The ACC Expert Consensus emphasizes personalized monitoring approaches based on stroke subtype, incorporating both extended and implantable cardiac monitoring devices to optimize arrhythmia detection rates in post-stroke patients
• Clinical teams now have specific guidance on evaluating and selecting between medical-grade and consumer-grade monitoring devices, enabling more informed decisions based on individual patient needs and circumstances
• The pathway establishes a collaborative framework between clinicians and patients, promoting shared decision-making in monitoring strategy selection and treatment planning to improve adherence and outcomes
• Recent landmark trials have strengthened the evidence supporting cardiac rhythm monitoring post-stroke, though questions remain about the impact of enhanced detection on secondary stroke prevention
• The consensus provides detailed protocols for implementing monitoring strategies across different healthcare settings, facilitating standardized approaches while maintaining flexibility for personalization

“Although improved monitoring leads to improved detection of arrhythmia after a stroke, there remains less clarity on the effect this detection has on secondary stroke prevention.”
– Michael T. Spooner, MD, MBA, FACC

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