Atrial fibrillation diagnosed following atroke: Dealing with a new clinical entity or just a matter of definition?

Detection of atrial fibrillation (AF) is critical to ensure an appropriate management plan is initiated, which may include the use of oral anticoagulants (OACs) to reduce the risk of stroke and mortality. OACs are usually indicated for individuals with AF and one or more additional stroke risk factor, for example, in clinical risk scores, such as the CHA₂DS₂-VASc. Of note, type of AF (paroxysmal, persistent, permanent) or burden of arrhythmia has not established sufficient clinical evidence to be included in the indication for OAC, especially since we are dealing with a dynamic arrhythmia where the number of paroxysms and burden change over time.