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Updated: May 10, 2026
23:33
The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation
Published on: February 28, 2012
Paroxysmal atrial fibrillation in cryptogenic stroke: a case-control study.
Alejandro A Rabinstein1, Jennifer E Fugate, Jay Mandrekar
1Department of Neurology, Mayo Clinic, Rochester, MN.
Summary
Brief episodes of paroxysmal atrial fibrillation (PAF) are common in cryptogenic stroke (CS) patients. PAF may be a cause of stroke in younger patients with specific imaging patterns, warranting further investigation.
Area of Science:
- Cardiology
- Neurology
Background:
- The role of brief paroxysmal atrial fibrillation (PAF) episodes in cryptogenic strokes (CS) remains unclear.
- Prolonged cardiac monitoring is used to detect occult causes of stroke.
Purpose of the Study:
- To compare the incidence of PAF in patients with CS versus patients with stroke of known cause (SKC).
- To investigate the potential link between PAF and CS, particularly in younger patients.
Main Methods:
- Prospective enrollment of 132 ischemic stroke patients within 3 months of stroke.
- Non-invasive cardiac monitoring for 3 weeks to detect PAF.
- Independent confirmation of PAF by two blinded cardiologists.
Main Results:
- PAF was detected in 25% of CS patients and 14% of SKC patients (P=.12).
- In patients <65 years, PAF was more frequent in the CS group (22% vs 3%; P=.07).
- Among younger CS patients with an embolic imaging pattern, PAF was observed in 21% versus 0% in SKC (P=.03).
Conclusions:
- Short PAF episodes are common in both CS and SKC, but their causative role is uncertain.
- PAF predominance in younger CS patients with embolic patterns suggests a potential causal link.
- Further research is needed to determine if prolonged monitoring can guide anticoagulation in CS.
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