For which stroke patients, if any, do you recommend implantable loop recorder for long-term cardiac monitoring and why?

Fantastic and pertinent question! I won't pretend that I have an answer, but do have a few thoughts that may help frame further discussion:

1. We derive our evidence for the efficacy of anticoagulation in stroke prevention from older trials designed to answer that specific question (SPAF, etc.).
2. In the...

The term embolic stroke of unknown source, or ESUS, implies an embolic type of stroke, i.e., sudden onset, cortical subcortical distribution, not lacunar, and with no demonstrated atherosclerosis either in the carotids or intracranially. Since we suspect a source of embolism, further evaluation with...

The question was framed as ESUS; i.e., embolic stroke. Typically, neurologists adjudicate whether a stroke is "embolic" or not but my experience is that younger neurologists rarely use the term "lacunar". Thus, if the stroke is clearly NOT due to atherosclerosis of the major intracranial vessels, th...

I usually consider ILR in patients stratified to high risk for PAF with suspected embolic stroke with so far negative workup for embolic causes including atherosclerotic disease (e.g., SYNC, aortic arch evaluation, athero embolism from mild to moderate intracranial stenosis), structural and culprit ...