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Absence of circulating microemboli in patients with lone atrial fibrillation
D G Nabavi1, A Allroggen, H Reinecke
1Department of Neurology, Westfälische Wilhelms-Universität, Münster, Germany.
Insights
Patients with lone atrial fibrillation (AF) on anticoagulation showed no microembolic signals (MES). This suggests reduced microemboli in low-risk AF, warranting further study on anticoagulation
Area of Science:
- Cardiology
- Neurology
- Vascular Medicine
Background:
- Atrial fibrillation (AF) is a significant risk factor for ischemic stroke.
- Microembolic signals (MES) are indicators of thromboembolic risk.
- Lone AF represents a subgroup with a lower stroke risk.
Purpose of the Study:
- To investigate the presence and quantity of MES in patients with lone AF.
- To assess microembolic activity in a low-risk AF population undergoing cardioversion.
Main Methods:
- Study included 15 patients with lone AF undergoing electric cardioversion.
- Effective anticoagulation was administered prior to cardioversion.
- Echocardiography and carotid duplex sonography excluded other embolism sources.
- One-hour unilateral transcranial Doppler monitoring was performed.
Main Results:
- Complete absence of MES was observed in all monitored patients.
- This finding aligns with the concept linking microembolisation to thromboembolic risk.
Conclusions:
- Patients with lone AF on effective anticoagulation exhibit no detectable MES.
- Further research is needed on less intensive anticoagulation in this group to clarify disease-specific microembolic activity.
Abstract:
Atrial fibrillation (AF) is a well-recognized independent risk factor of ischemic stroke. The aim of this study was to investigate the amount of microembolic signals (MES) in 15 patients with 'lone' AF representing the subgroup of AF patients with the lowest lifelong risk of stroke. All patients had been put on effective anticoagulation due to a scheduled electric cardioversion. Additional cardiac and arterial sources of embolism were excluded by echocardiography and extracranial color-coded duplex sonography of the carotid arteries. Unilateral one-hour transcranial Doppler monitorings revealed complete absence of MES in this series. This observation fits the concept that the amount of microembolisation is related to the risk of manifest thromboembolism. Further studies on this patient group treated with less intensive antihemostatic therapy should be undertaken to define more clearly the disease-specific microembolic activity.