When would you consider long-term cardiac monitoring to look for atrial fibrillation in patients with mitral stenosis given their baseline elevated risk for atrial fibrillation and thrombosis?

When do you consider long-term cardiac monitoring for atrial fibrillation in patients with mitral stenosis, given their elevated risk for atrial fibrillation and thrombosis?

• I recommend long-term cardiac monitoring for all patients with mitral stenosis
• I only recommend monitoring for patients with additional risk factors such as moderate or severe mitral stenosis, severe left atrial enlargement, or left atrial smoke on echocardiography
• I only recommend monitoring if the patient experiences symptoms suggestive of atrial fibrillation
• I do not recommend routine long-term cardiac monitoring due to the uncertain clinical benefit of detecting subclinical atrial fibrillation
• Other