Randomized trials show superiority for carotid endarterectomy over stenting in patients with symptomatic stenosis (> 50%) of the internal carotid This could reduce the need for combination therapy with OAC and antiplatelet drugs in those with AF. Current practice is to treat all potential stroke risk factors including AF and carotid stenosis. Those who have had successful carotid revascularization are typically managed with OAC alone. In patients with carotid stenosis not treated by revascularization (including those with asymptomatic disease) as well as AF, the optimal management is not known and requires further randomized data; meanwhile, decisions need to be tailored to the individual patient. Recommendations 39. In patients with AF and symptomatic carotid stenosis (> 50%), we suggest carotid revascularization with endarterectomy or stenting in addition to OAC as indicated (Weak recommendation, moderate quality evidence). TABLE 10 ] Phases of Screening for AF in Cryptogenic Stroke Patients, Methods and Incidence of AF Diagnosed355 4 Sequential Phases of Screening Cardiac Monitoring Methods % (95% CI) Diagnosed With Poststroke AF Phase 1 (emergency room) Phase 2 (in hospital) Serial ECG, continuous inpatient ECG monitoring, continuous inpatient cardiac telemetry, and in-hospital Holter monitoring Phase 3 ( rst ambulatory period) Phase 4 (second ambulatory period) Mobile cardiac outpatient telemetry, external loop recording, and implantable loop recording See Table 1 legend for expansion of abbreviation. 1176 Evidence-Based Medicine [ 1 5 4 # 5 C H E S T N O V E M B E R 2 0 1 8 ] 40. In patients with AF and carotid stenosis treated with revascularization, we suggest OAC therapy, without long-term antiplatelet therapy (Ungraded consensus-based statement). Remark: There is limited evidence to guide the optimal treatment of patients with AF and carotid stenosis not requiring revascularisation. 