New Survey Finds Majority of Stroke Survivors Are Not Using Long-Term Heart Monitoring, Increasing Risk for Secondary Stroke

Updated on May 12, 2023

A targeted survey released by patient advocacy group, United Stroke Alliance, with support from Medtronic, found that while nearly 80% of stroke survivors and 90% of caregivers were concerned about the risk of a second stroke, only 6% (2 of 30 patients) were prescribed an insertable cardiac monitor (ICM). Inserted just underneath the skin for up to several years, ICMs are able to detect intermittent abnormal heart rhythms in patients, such as atrial fibrillation (AF), which can lead to stroke.

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Approximately one in four stroke survivors will experience another stroke within five years.i In some cases, these patients may have AF, an irregular heartbeat that is associated with a five-fold greater risk of stroke. Long-term, continuous heart monitoring with an ICM can be a critical tool for detecting AF and informing secondary stroke prevention treatment strategies; yet the recent sampling of stroke survivors within the United Stroke Alliance community suggests many are not receiving long-term monitoring – or any heart monitoring – following stroke.

In the survey, 30% of stroke survivors reported they were given some form of short-term heart monitoring after their stroke, only 6% received an ICM for long-term monitoring, while nearly half (43%) did not receive any form of heart monitoring, either short- or long-term.

“Stroke is often a life-altering event, and survivors are not only navigating recovery, but they are also often working with their care team to build a customized treatment plan to prevent a second stroke,” says Marylee Nunley, co-founder and national board member at the United Stroke Alliance. “Understanding their individual risk factors and the latest treatment and monitoring options available is not only critical to their long-term recovery, but it can also be a life-saver.”

Gaps in the Stroke Care Pathway

These survey findings reveal a critical gap in stroke management care pathways as recent clinical research shows long-term heart monitoring significantly increases AF detection rates that short-term monitoring often does not detect. In fact, in 78% of stroke patients, AF would go undetected if monitored for only 30 days compared to a year (STROKE AF Study).ii Clinical studies have also shown that, compared to conventional cardiac monitoring, long-term cardiac monitoring increases AF detection and enhances the speed with which patients are given treatment, ultimately cutting the risk of recurrent stroke in half.iii

Of the patients surveyed, just over one-third (37%) of stroke survivors report being referred to a cardiologist or electrophysiologist following their stroke, which is consistent with findings from the DiVERT clinical study phase one results that underscored the need for stronger, standardized care pathways. Yet, stroke survivors rank being referred to a cardiologist or electrophysiologist – in addition to participating in survivor patient groups – as the most helpful ways to learn more about AF and heart monitoring, highlighting the need to strengthen the referral pathway.

“We’ve learned from clinical studies that long-term heart monitoring with a Medtronic ICM following a stroke leads to detecting more atrial fibrillation,” said Alan Cheng, M.D., chief medical officer of the Medtronic Cardiac Rhythm Management operating unit. “Often, the impact of a second stroke is more severe due to the additional damage to the brain. That’s why it is important that stroke patients have the right monitoring in place to inform their treatment plan and potentially lessen the risk of a second stroke.”

To find more information and resources from the United Stroke Alliance, visit, and to learn more about the connection between AF and stroke, as well as long-term cardiac monitoring, visit

About the Survey
These results are based on an online survey issued to the United Stroke Alliance community, a non-profit organization dedicated to uniting & educating people about the prevention, awareness and recovery of stroke for survivors, caregivers and their families. Forty-one responses were received from stroke patients (30) and caregivers (11). Of the stroke survivor respondents, 76.6% were female and 23.3% were male, with 73% between the ages of 40-69 and 27% over the age of 70.

About The United Stroke Alliance
The United Stroke Alliance team is made up of passionate individuals who tirelessly strive to make a difference in not only stroke survivors and caregivers, but also for the members of every community. It all began in 2004 when one caregiver wanted to improve the quality of life for local stroke survivors and caregivers through a weekend retreat. From a single person in a single community, the reach has been extended to communities throughout the country educating millions of people on the signs of stroke as well as supporting thousands of stroke survivors, caregivers and their family members in through their stroke recovery.

ii Bernstein RA, Kamel H, Granger CB, et al. Effect of Long-term Continuous Cardiac Monitoring vs Usual Care on Detection of Atrial Fibrillation in Patients With Stroke Attributed to Large- or Small-Vessel Disease: The STROKE-AF Randomized Clinical Trial. JAMA. 2021;325(21):2169–2177. doi:10.1001/jama.2021.6470
iii Tsivgoulis G, et al. Stroke. 2019;50:2175-2180

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