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Updated: May 16, 2026
Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation
Published on: July 20, 2022
Prediction of atrial fibrillation after ischemic stroke using P-wave signal averaged electrocardiography
Kenji Yodogawa1, Yoshihiko Seino, Toshihiko Ohara
1Division of Cardiology, Hepatology, Geriatrics, and Integrated Medicine, Department of Internal Medicine, Nippon Medical School, Tokyo 113-8603, Japan. yodo@nms.ac.jp
Background:
Atrial fibrillation (AF) is highly prevalent in patients with ischemic stroke, but the diagnosis is often difficult.
Methods:
This study consisted of 68 stroke patients in sinus rhythm without history of AF. All patients underwent P-wave signal-averaged electrocardiography (P-SAECG), echocardiography, 24-h Holter monitoring, and measurement of plasma B-type natriuretic peptide (BNP) concentrations at admission.
Results:
An abnormal P-SAECG was found in 34 of 68 stroke patients. In the follow-up period of 11 ± 4 months, AF developed in 17 patients (AF group). The remaining 51 patients were classified as the non-AF group. The prevalence of atrial late potentials (ALP) on P-SAECG, and the number of premature atrial contractions (PACs) were significantly higher in the AF group than those in the non-AF group (88.2% vs 37.3%; p<0.001, 149 ± 120 vs 79 ± 69; p=0.030, respectively). However, there were no significant differences in age, left atrial dimension, or BNP concentrations between both groups. Cox proportional hazards analysis revealed that the presence of ALP (risk ratio 11.15; p=0.002) and frequent PACs (more than 100/24h) (risk ratio 4.53; p=0.007) had significant correlation to the occurrence of AF.
Conclusions:
ALP may be a novel predictor of AF in stroke patients. P-SAECG should be considered in stroke of undetermined etiology.
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