Abstract：The insertable cardiac monitor (ICM) is a subcutaneous implanted device that can perform continuous ambulatory ECG monitoring and is a good tool for clinicians to evaluate rare or potential asymptomatic arrhythmias. Although unexplained syncope is still the most common cause of ICM implantation, ICM is increasingly being used to monitor atrial fibrillation（AF）. Recent studies have shown that AF can be detected in a large number of patients with cryptogenic stroke only through longterm monitoring provided by ICM, which greatly increase the detection rate of asymptomatic atrial fibrillation. However, there is a lack of guidelines for the detection of subclinical atrial fibrillation in patients with cryptogenic stroke. More studies are needed to provide reliable evidence. In addition, in recent years, several studies have used ICM with automatic atrial fibrillation detection algorithm and continuous remote monitoring to guide anticoagulant therapy in patients with atrial fibrillation, which may potentially reduce the risk of bleeding.However,more studies are needed to confirm the effectiveness of ICM in guiding individualized anticoagulant therapy in patients with atrial fibrillation.
