Buck BH, Hill MD, Quinn FR, et al. - In this randomized clinical trial, researchers sought to determine whether 12 months of implantable loop recorder monitoring detects more occurrences of atrial fibrillation (AF) in patients with a recent ischemic stroke than conventional external loop recorder monitoring for 30 days. Candidates were randomly assigned 1:1 to prolonged electrocardiographic monitoring with either an implantable loop recorder (n = 150) or an external loop recorder (n = 150) with follow-up visits at 30 days, 6 months, and 12 months. Participants in the study were 300 patients (median age, 64.1 years [interquartile range, 56.1 to 73.7 years]). When compared with prolonged external monitoring for 30 days, implantable electrocardiographic monitoring for 12 months resulted in a significantly higher proportion of patients with AF detected over 12 months in patients with ischemic stroke and no prior evidence of AF. More research is needed to compare clinical outcomes and the relative cost-effectiveness of these monitoring strategies.