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Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
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Stroke severity in concomitant cardiac sources of embolism in patients with atrial fibrillation

Young Dae Kim1, Bosuk Park, Myoung Jin Cha

  • 1Department of Neurology, Severance Hospital Integrative Research Institute for Cerebral and Cardiovascular Diseases, Yonsei University College of Medicine, Seoul, Republic of Korea.

Journal of the Neurological Sciences
|September 14, 2010
PubMed

Insights

Patients with atrial fibrillation (AF) and additional cardiac embolism sources experienced more severe strokes. These findings highlight the impact of multiple embolism sources on stroke severity in AF patients.

Area of Science:

  • Cardiology
  • Neurology
  • Vascular Medicine

Background:

  • Atrial fibrillation (AF) is a primary cause of cardioembolic stroke.
  • Multiple cardiac sources of embolism can coexist with AF.
  • These sources may lead to thrombi of varying composition, age, and size, potentially affecting stroke severity.

Purpose of the Study:

  • To investigate if stroke severity differs in patients with AF who have concomitant potential cardiac sources of embolism compared to those without.
  • To analyze the relationship between multiple cardiac embolism sources and stroke characteristics in AF patients.

Main Methods:

  • A 10-year retrospective study of consecutive cerebral infarction patients with AF who underwent transesophageal echocardiography.
  • Classification of high- and medium-risk potential cardiac sources of embolism based on established criteria.
  • Comparison of initial stroke severity (NIH Stroke Scale) and infarct sizes between groups.

Main Results:

  • 181 out of 266 (68.0%) AF patients had concomitant potential cardiac sources of embolism.
  • Left atrial thrombus and spontaneous echo contrast were the most frequent additional sources.
  • Patients with additional sources showed significantly higher NIH Stroke Scale scores (median 6 vs. 3) and larger infarct diameters (45.4 mm vs. 35.5 mm).
  • Symptomatic artery occlusion was more common in patients with concomitant embolism sources.

Conclusions:

  • Concomitant potential cardiac sources of embolism are frequent in stroke patients with AF.
  • Strokes are significantly more severe in AF patients with additional cardiac embolism sources.
Abstract

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