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[Bidirectional relationship between atrial fibrillation and stroke.]

The temporal relationship between atrial fibrillation (AF) and stroke has always been considered one-way: the presence of arrhythmia favors the occurrence of stroke. Recent studies have questioned this association and raised the possibility that it may be bidirectional. Some ischemic events are actually due to stasis following AF episodes. Others are caused by the same substrate, atrial cardiomyopathy, which can cause both AF and stroke. Arrhythmia would in turn be both a possible causal factor and a marker of thrombo-embolic risk. It is therefore essential, in addition to always looking for a possible AF after a stroke, using the new technologies of prolonged cardiac monitoring, to highlight, regardless of the history, the common risk factors, whose treatment can improve the prognosis, not only with respect to prevention of thrombo-embolisms but also of heart failure and mortality.