Bernstein RA, Kamel H, Granger CB, et al. - This study was undertaken to determine if long-term cardiac monitoring is more effective than usual care for atrial fibrillation (AF) detection in patients with stroke attributed to large- or small-vessel disease through 12 months of follow-up. Eligible patients were 60 years or older, or 50 to 59 years old with at least 1 additional stroke risk factor and had an index stroke attributed to large- or small-vessel disease within 10 days of insertable cardiac monitor (ICM) insertion. Patients in the intervention group (n = 242) received ICM insertion within 10 days of the index stroke; patients in the control group (n = 250) received site-specific usual care, which included external cardiac monitoring such as 12-lead electrocardiograms, Holter monitoring, telemetry, or event recorders. Four hundred seventeen (84.8%) of the 492 patients who were randomized (mean [SD] age, 67.1 [9.4] years; 185 [37.6%] women) completed 12 months of follow-up. Monitoring with an ICM detected significantly more AF over 12 months in patients with stroke caused by large- or small-vessel disease than usual care. However, more research is needed to determine whether detecting AF in these patients is clinically significant.