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Afib Prevalence High Following Cryptogenic Stroke
J Stroke Cerebrovasc Dis; ePub 2017 Oct 9; Carrazco, et al
Paroxysmal atrial fibrillation and flutter (PAF) was detected with high prevalence following early post-cryptogenic stroke implantable loop recorder (ILR) implantation and resulted in significant management changes, a recent study found. Older age, increased PR interval, left atrial (LA) enlargement, and lower HbA1c are significantly associated with PAF detection. A retrospective study was conducted of cryptogenic ischemic stroke (CIS) patients (n=100, mean age 65.8 years; 52.5% female) who underwent ILR insertion during, or soon after, index stroke admission. Patients were prospectively followed by the study’s cardiac electrophysiologist who confirmed the PAF diagnosis. They found:
- PAF was detected in 31 of 100 (31%) CIS patients, and anticoagulation was initiated in almost all (30 of 31, 96.8%).
- Factors associated with PAF detection include older age (mean [year] 72.9 vs 62.9), white race, prolonged PR interval, larger LA diameter and LA volume index, and lower hemoglobin HbA1c.
- Controlling for age and obesity was independently associated with PAF detection.
Carrazco C, Golyan D, Kahen M, Black K, Libman RB, Katz JM. Prevalence and risk factors for paroxysmal atrial fibrillation and flutter detection after cryptogenic ischemic stroke. [Published online ahead of print October 9, 2017]. J Stroke Cerebrovasc Dis. doi:10.1016/j.jstrokecerebrovasdis.2017.08.022.