Ischemic stroke phenotype in patients with nonsustained atrial fibrillation
Author
Arsava, E. M.
Bas, D. F.
Atalar, Ergin
Has, A. C.
Oguz, K. K.
Topcuoglu, M. A.
Date
2015Source Title
Stroke
Print ISSN
0039-2499
Publisher
Lippincott Williams and Wilkins
Volume
46
Issue
3
Pages
634 - 640
Language
English
Type
ArticleItem Usage Stats
136
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views
117
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downloads
Abstract
Background and Purpose: The widespread use of ambulatory cardiac monitoring has not only increased the detection of high-risk arrhythmias like persistent and paroxysmal atrial fibrillation (AF), but also made it possible to identify other aberrations such as short-lasting (<30 seconds) irregular runs of supraventricular tachycardia. Ischemic stroke phenotype might be helpful in understanding whether these nonsustained episodes play a similar role in stroke pathophysiology like their persistent and paroxysmal counterparts. Methods: In a consecutive series of patients with ischemic stroke, we retrospectively determined clinical and imaging features associated with nonsustained AF (n=126), defined as <30-second-lasting supraventricular tachyarrhythmias with irregular RR interval on 24-hour Holter monitoring, and compared them to patients with persistent/paroxysmal AF (n=239) and no AF (n=246). Results: Patients with persistent/paroxysmal AF significantly differed from patients with nonsustained AF by a higher prevalence of female sex (odds ratio [95% confidence interval], 1.8 [1.1-2.9]), coronary artery disease (1.9 [1.1-3.0]), and embolic imaging features (2.7 [1.1-6.5]), and lower frequency of smoking (0.4 [0.2-0.8]) and hyperlipidemia (0.5 [0.3-0.8]). In contrast, patients with no AF were younger (0.5 [0.4-0.6] per decade) and more likely to be male (1.7 [1.0-2.8]) in comparison with nonsustained AF population. The prevalence of nonsustained AF was similar among cryptogenic and noncryptogenic stroke patients (32% versus 29%). Voxel-wise comparison of lesion probability maps revealed no significant difference between cryptogenic stroke patients with and without nonsustained AF. Conclusions: Clinical features of patients with nonsustained AF exhibited an intermediary phenotype in between patients with persistent/paroxysmal AF and no AF. Furthermore, imaging features did not entirely resemble patterns observed in patients with longer durations of AF.
Keywords
AmbulatoryAtrial fibrillation
Electrocardiography
Magnetic resonance imaging
Adult
Aged
Article
Atherosclerosis
Atrial fibrillation
Brain ischemia
Cerebrovascular accident
Coronary artery disease
Diabetes mellitus
Female
Holter monitoring
Human
Hyperlipidemia
Hypertension
Major clinical study
Male
Middle aged
Persistent atrial fibrillation
Phenotype
Priority journal
Retrospective study
RR interval
Smoking
Stroke patient
Supraventricular tachycardia
Transient ischemic attack
Very elderly
Atrial fibrillation
Brain ischemia
Electrocardiography
Pathophysiology
Probability
Procedures
Tachycardia, Supraventricular
Aged
Aged, 80 and over
Atrial Fibrillation
Brain Ischemia
Electrocardiography, Ambulatory
Female
Humans
Male
Middle Aged
Phenotype
Probability
Retrospective Studies
Stroke
Tachycardia
Supraventricular
Permalink
http://hdl.handle.net/11693/22347Published Version (Please cite this version)
https://doi.org/10.1161/STROKEAHA.114.006396Collections
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