ambulatory ECG monitoring in the Management of atrial fibrillation among post-myocardial infarction patients

Satoshi Yoshida; K. Kobayashi; T. Kato

doi:10.5281/zenodo.22814523

Authors

Satoshi Yoshida Division of Cardiovascular Medicine, Colorado Institute for Advanced Cardiovascular Medicine Author https://orcid.org/0412-7187-6838-6511
K. Kobayashi Department of Clinical Cardiovascular Medicine, Colorado Institute for Advanced Cardiovascular Medicine Author https://orcid.org/6563-0403-8995-0930
T. Kato Division of Cardiovascular Medicine, Tigris Institute for Advanced Cardiovascular Medicine Author https://orcid.org/0512-4576-8336-6944

DOI:

https://doi.org/10.5281/zenodo.22814523

Keywords:

atrial fibrillation, ambulatory ECG monitoring, myocardial infarction, stroke prevention, implantable loop recorder

Abstract

Graphical abstract

Background: Atrial fibrillation (AF) complicates a substantial proportion of myocardial infarction (MI) admissions and is independently associated with higher mortality, yet much post-MI AF is paroxysmal and escapes brief inpatient telemetry or standard Holter recording.

Objective: This review synthesizes evidence on ambulatory ECG monitoring for detecting and managing AF after myocardial infarction, and how findings should translate into anticoagulation and rhythm-control decisions.

Methods: We reviewed cohort data on post-MI AF epidemiology, comparative studies of Holter, patch, and loop-recorder monitoring, plus randomized evidence on AF duration, stroke risk, and guideline recommendations.

Findings: Diagnostic yield for AF rises with monitoring duration and repetition, from Holter recording through multi-year loop-recorder surveillance; stroke risk from device-detected AF scales with episode duration and vascular risk, and post-MI patients typically already carry an elevated CHA2DS2-VASc score that makes detected AF more actionable than in lower-risk screening.

Conclusions: A structured, risk-stratified ambulatory monitoring pathway after myocardial infarction, matching intensity and duration to stroke risk and interpreting AF burden jointly with overall risk, offers a practical route to meaningful stroke prevention.

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