In one in three cases of severe stroke, experts fail to identify the cause of this type of stroke. In this way, there is a risk of suffering a new stroke by not applying the most appropriate preventive treatment, which generates uncertainty in the patient. Now, neurologists from the Ictus Unit of the Vall d'Hebron University Hospital in collaboration with the Arrhythmia Unit of the same center and experts from the Vall d'Hebron Research Institute (VHIR) have led a multicenter research project sponsored by the Carlos III Institute that implements a new diagnostic technique, the textile wearable Holter Nuubo(R) (Holter cloth vest), for use in daily clinical practice. The Ictus units of the Hospital Clínico Universitario of Valladolid and the Virgen Macarena and Virgen del Rocío University Hospitals of Seville collaborate in the project. As described in the results of the project, published in the International https://www.ncbi.nlm.nih.gov/pubmed/29107360 Journal of Cardiology, this new protocol significantly improves the detection of paroxysmal atrial fibrillation, one of the main causes of severe stroke.As explained by Dr. Jorge Pagola, principal investigator of the study, deputy physician of the Vall d'Hebron Stroke Unit and researcher of the http://en.vhir.org/portal1/grup-equip.asp?s=recerca&contentid=186813 Neurovascular Diseases Group of VHIR, "in one of every three patients who suffer a serious stroke we can not detect the cause. But it is estimated that, in half of the cases, the cause is paroxysmal atrial fibrillation, a type of arrhythmia that is very complicated to detect with conventional protocols because it appears and disappears.When a paroxysmal atrial fibrillation course occurs, the atria of the heart do not contract properly, which facilitates the formation of thrombi that go to the brain and cause stroke. To detect it, the Holter that the patient carries for only 24 hours has been used classically, which "only manages to detect up to 2% of the paroxysmal atrial fibrillations that are behind a severe stroke", says Dr. Pagola. To perform longer monitoring there are two types of devices: the implantable Holter and the external recorder. The implantable Holter is a small electronic device that, similar to a pacemaker, is implanted under the skin and records the electrical activity of the heart. It demands surgery and presents a high price. On the other hand, external registrars require adhesive elements glued to the skin that often cause irritation of the bonding areas, which makes it difficult to maintain monitoring for more than a week.For the study with the protocol designed by the Vall d'Hebron experts, the first carried out worldwide with a cloth Holter, a group of 215 patients was selected who wore the cloth Holter vest for 30 days. "The patient wears the Holter as if it were a vest, under the clothes, for 30 days," explains Dr. Pagola. At two weeks and at the end of 30 days, he comes to the hospital so we can read the recorded information and check if he presents paroxysmal atrial fibrillation, although he can also send this information directly from the Holter through an app on his mobile phone " . Experts have found that, "with the wearable textile Holter are detected up to 20% of cases of this type of atrial fibrillation, since being based on a vest without adhesives does not cause skin irritation and compliance of the patient is much more suitable, "says Dr. Pagola. This is one of the main keys of the protocol, since the fact that patients tolerate the vest for 30 days allows registering a greater number of atrial fibrillations and making a much more reliable reading of the data ".Detecting the cause of the stroke is essential to apply the correct treatment. "It is known that the standard treatment of stroke, which is aspirin 100 milligrams every day, is not effective in the event that the stroke is due to the presence of paroxysmal atrial fibrillation," Dr. Pagola remarked. In this case, it is preferable to opt for a classic oral anticoagulant or a new direct-acting oral anticoagulant".