[Atrial electrophysiological study of unexplained cerebrovascular disorders]

The aim of this study was to detect possible atrial electrophysiological abnormalities in patients with unexplained embolic cerebrovascular accidents without overt atrial arrhythmias. This group was compared with normal controls and a group of patients with paroxysmal atrial fibrillation. Sixty-six patients were studied: Group I normal controls (N = 20); Group II patients with CVA (N = 26) and Group III, patients with paroxysmal atrial fibrillation (N = 20). Each group was divided into 2 subgroups according to age (over and under 45 years). The following parameters were taken into consideration: parameters correlated to atrial excitability (effective and functional refractory periods, adaptation of these refractory periods, intraatrial conduction--A1 and A2, S1A1, S2A2 intervals--, index of latent vulnerability); provocative testing by the extrastimulus technique; classical indices of atrioventricular conduction and sinus node function. In subjects over 45 years of age, the effective refractory periods were shorter in Group III (214 +/- 33 ms) and II (214 +/- 32 ms) than in the control Group I (248 +/- 21 ms), p less than 0.01. This difference was not apparent in younger patients. Inadaptation of the refractory periods was demonstrated equally in Groups II and III in all ages whilst the control subjects showed normal adaptation, p less than 0.05. Intraatrial A1 and especially A2 conduction was significantly prolonged in Group III (94.5 +/- 24 ms) and II (87 +/- 14 ms) compared with the control group (69 +/- 8 ms), p less than 0.01, especially in younger subjects.(ABSTRACT TRUNCATED AT 250 WORDS)