Cardiac Diagnostics and Monitoring


Monitor longer. Fight secondary stroke.

Reveal LINQ and LINQ II ICMs shown horizontally surrounded by blue circles and dots


Secondary stroke prevention

Decorative element

One in four stroke survivors will experience another stroke within five years.1

Cryptogenic, large-vessel, and small-vessel stroke patients can benefit from insertable cardiac monitoring (ICM) for atrial fibrillation (AF) detection, which helps inform secondary stroke prevention strategies.

Up to 30% of cryptogenic stroke patients and 21.7% of large and small vessel stroke patients have undetected paroxysmal AF at three years post-stroke.2,3 

The link between AF and stroke

Watch clinicians discuss the importance of long-term cardiac monitoring to detect AF and prevent secondary stroke.

Patient outcomes

Cryptogenic stroke/TIA patients who underwent prolonged cardiac monitoring show a 55% decreased risk of recurrent stroke.4

Decorative element

Additionally, compared to external monitors, ICM use in cryptogenic stroke patients was associated with5:

  • Faster time to AF diagnosis
  • Faster time to oral anticoagulation initiation
  • Reduced readmissions
  • Reduced rate of mortality

Why monitor longer?

When it comes to detecting AF in stroke patients, short-term monitoring is not enough. In fact, neurology and cardiology guidelines recommend long-term cardiac monitoring with ICMs for AF detection in cryptogenic stroke patients.6–9

Randomized trials have shown that AF is diagnosed in stroke patients well beyond 30 days.


  • 30% of cryptogenic stroke patients have AF detected up to three years post-stroke.
  • 84 days median time to AF detection in cryptogenic stroke patients at 12 months.
  • 88% of cryptogenic stroke patients who had AF would have been missed if only monitored for 30 days.


  • 21.7% of large and small vessel stroke patients have AF detected up to three years post-stroke.
  • 99 days median time to AF detection in large and small vessel stroke patients at 12 months.
  • 87% of large and small vessel stroke patients with AF would have been missed if only monitored for 30 days.


  • 15.3% AF detected with Medtronic ICM versus 4.7% with 30-day external loop recorder.
  • 70% of patients with AF were detected beyond 30 days.
  • All study patients with a “definite AF/high probability” diagnosis were started on oral anticoagulant.

Why ICMs for secondary stroke prevention?

Watch as experts discuss the role of ICMs for secondary stroke prevention.

Discover Medtronic ICMs.

Accuracy matters. When finding and treating AF in a stroke patient could mean preventing a recurrent stroke, you need a cardiac monitor you can rely on. Medtronic ICMs are the most accurate ICMs on the market,11–23 and are proven 3x more effective for AF detection post-stroke than 30-day external monitors.10

LINQ II and Reveal LINQ insertable cardiac monitors shown horizontally

Studies have also demonstrated that Medtronic ICMs are cost-effective for the prevention of secondary stroke through AF detection and subsequent medical management in a U.S. cryptogenic stroke population. In fact, immediate Medtronic ICM placement post-stroke was found to be cost-effective versus the standard of care, and cost-saving versus using an external monitor first.24 There is also a 50.2% estimated decrease in patient out-of-pocket costs with an ICM compared to using a 30-day monitor first.25

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AHA/ASA Cryptogenic Stroke Initiative

Access educational resources for healthcare professionals and patients.

On-demand education

Watch webinars on secondary stroke prevention and the role of insertable cardiac monitoring.

Establish a stroke pathway.

Get information about how to get started with creating a stroke pathway.


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Mohan KM, Wolfe CDA, Rudd AG, Heuschmann PU, Kolominsky-Rabas PL, Grieve AP. Risk and cumulative risk of stroke recurrence: a systematic review and meta-analysis. Stroke. May 2011;42(5):1489–1494.


Sanna T, Diener HC, Passman RS, et al. Cryptogenic Stroke and Underlying Atrial Fibrillation (CRYSTAL AF). N Engl J Med. June 26, 2014;370(26):2478–2486.


Bernstein RA, et al. Atrial Fibrillation In Patients With Stroke Attributed to Large- or Small-Vessel Disease: 3-Year Results From the STROKE AF Randomized Clinical Trial. JAMA Neurol. 2023;80(12):1277–1283.


Tsivgoulis G, Katsanos AH, Grory BM, et al. Prolonged Cardiac Rhythm Monitoring and Secondary Stroke Prevention in Patients with Cryptogenic Cerebral Ischemia. Stroke. August 2019;50(8):2175–2180.


Yaghi S, Ryan MP, Gunnarsson CL, et al. Longitudinal outcomes in cryptogenic stroke patients with and without long-term cardiac monitoring for atrial fibrillation. Heart Rhythm O2. February 13, 2022;3(3):223–230.


Rubiera M, Aires A, Antonenko K, et al. European Stroke Organisation (ESO) guideline on screening for subclinical atrial fibrillation after stroke or transient ischaemic attack of undetermined origin. Eur Stroke J. September 2022;7(3):VI.


Kleindorfer DO, Towfighi A, Chaturvedi S, et al. 2021 Guideline for the Prevention of Stroke in Patients With Stroke and Transient Ischemic Attack: A Guideline From the American Heart Association/American Stroke Association. Stroke. July 2021;52(7):e364–3467.


Hindricks G, Potpara T, Dagres N, et al. 2020 ESC Guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS): The Task Force for the diagnosis and management of atrial fibrillation of the European Society of Cardiology (ESC) Developed with the special contribution of the European Heart Rhythm Association (EHRA) of the ESC. Eur Heart J. February 1, 2021;42(5):373–498.


January CT, Wann LS, Calkins H, et al. 2019 AHA/ACC/HRS Focused Update of the 2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society. J Am Coll Cardiol. July 9, 2019;74(1):104–132.


Buck BH, Hill MD, Quinn FR, et al. Effect of Implantable vs Prolonged External Electrocardiographic Monitoring on Atrial Fibrillation Detection in Patients With Ischemic Stroke: The PER DIEM Randomized Clinical Trial. JAMA. June 1, 2021;325(21):2160–2168.


Pürerfellner H, Sanders P, Sarkar S, et al. Adapting detection sensitivity based on evidence of irregular sinus arrhythmia to improve atrial fibrillation detection in insertable cardiac monitors. Europace. November 1, 2018;20(FI_3):f321–f328.


Nölker G, Mayer J, Boldt L, et al. Performance of an Implantable Cardiac Monitor to Detect Atrial Fibrillation: Results of the DETECT AF Study. J Cardiovasc Electrophysiol. December 2016;27(12):1403–1410.


Confirm Rx™* ICM K163407 FDA Clearance Letter. 2017.


Confirm Rx ICM K182981 FDA Clearance Letter. 2019.


Jot Dx™* ICM K212206 FDA Clearance Letter. 2021.


Monitoring Devices Merlin™* PCS Help Manual for SJM Confirm™*, Confirm Rx ICM, Jot Dx Manual. 2021.


BIOTRONIK BioMonitor™* 2 Technical Manual. 2017.


BIOTRONIK BIOMONITOR III Technical Manual. 2020.


BIOTRONIK BIOMONITOR IIIm Technical Manual. 2020.


BIOTRONIK BIOMONITOR III. K190548 FDA Clearance. 2019.


BIOTRONIK BIOMONITOR IIIm. K201865 FDA Clearance. 2020.


Lux-Dx™* ICM K212206 FDA Clearance Letter. 2020.


Lux-Dx ICM User Manual. 2020.


Sawyer LM, Witte KK, Reynolds MR, et al. Cost-effectiveness of an insertable cardiac monitor to detect atrial fibrillation in patients with cryptogenic stroke. J Comp Eff Res. February 2021;10(2):127–141.


Chalfoun N, Pierobon J, Rosemas SC, et al. A cost comparison of atrial fibrillation monitoring strategies after embolic stroke of undetermined source. Am Heart J Plus: Cardiol Res Pract. September 2022;21:100195.