Atrial Tachyarrhythmias and Stroke: Temporal Relationship and Stroke Subtypes

التفاصيل البيبلوغرافية
العنوان: Atrial Tachyarrhythmias and Stroke: Temporal Relationship and Stroke Subtypes
المؤلفون: Hugh Blackie, Vincent Thijs, Leonid Churilov, Hui-Chen Han, Tina Lin, Andrew W. Teh, Elizabeth F. Jones, Mark Horrigan, Omar Farouque, Han S. Lim
المصدر: Cerebrovascular Diseases. 52:166-170
بيانات النشر: S. Karger AG, 2022.
سنة النشر: 2022
مصطلحات موضوعية: Neurology, Neurology (clinical), Cardiology and Cardiovascular Medicine
الوصف: Background and Purpose: Research into the temporal relationship between atrial tachyarrhythmias (atrial tachycardia [AT] and atrial fibrillation [AF]) and stroke has produced conflicting findings. Systematic categorization of stroke subtypes may help clarify the discussion. Objectives: The objective of the study was to examine the presence and timing of AT/AF in relation to ischemic stroke subtypes, categorized as either cardioembolic (CE) or non-CE. Methods: Consecutive patients presenting to the Austin Hospital with acute stroke from 2012 to 2019 and a cardiac implantable electronic device (CIED) were identified. Using a case-control design, the temporal proximity of AT/AF episodes in the 90 days prior to stroke was compared in the CE and non-CE stroke groups. Results: 5,591 patients presented to the Austin Hospital with acute stroke from 2012 to 2019, of whom 31 patients with an ischemic stroke and a CIED with ≥90 days of monitoring were identified. Twelve strokes were adjudicated as CE and 19 as non-CE by a stroke neurologist. Six of the 12 CE stroke patients (50%) experienced AT/AF within 30 days preceding their stroke, while none of the 19 non-CE stroke patients recorded any AT/AF in the same period (p = 0.001). Four CE stroke patients (33%) had no AT/AF preceding their strokes at any time. The odds ratio for CE stroke was highest (39; 95% confidence interval [CI]: 1.92–791.5) when AT/AF occurred in the 30 days prior, declining to 20.65 (95% CI: 1.00–427.66) and 6.07 (95% CI: 0.94–39.04) in the subsequent 31–60- and 61–90-day windows, respectively. Conclusions: CE strokes were associated with a significantly higher proportion of preceding AT/AF compared with non-CE strokes. These findings support a potential temporal relationship between AT/AF and CE stroke and demonstrate that stroke subtyping can better characterize the relationship between AF and ischemic stroke. However, this study’s findings are limited by its sample size and small number of informative cases.
تدمد: 1421-9786
1015-9770
URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_________::aac3796c8d503d0aeaa5d11a328d7643
https://doi.org/10.1159/000526088
حقوق: CLOSED
رقم الأكسشن: edsair.doi...........aac3796c8d503d0aeaa5d11a328d7643
قاعدة البيانات: OpenAIRE