Prolonged QTc interval predicts poststroke paroxysmal atrial fibrillation

Area of Science:

• Cardiology
• Neurology
• Electrocardiography

Background:

• Paroxysmal atrial fibrillation (PAF) is challenging to detect in acute ischemic stroke patients.
• Early detection of PAF is crucial for stroke management and prevention.

Purpose of the Study:

• To evaluate the predictive value of a prolonged QT interval corrected for heart rate (QTc) for detecting PAF in patients following an acute ischemic stroke.

Main Methods:

• A total of 972 patients with acute ischemic stroke were initially enrolled.
• After exclusions, 744 patients were analyzed for clinical characteristics and ECG findings.
• Multiple logistic regression identified predictors of poststroke PAF.

Main Results:

• De novo PAF was detected in 9.3% (69 patients) of the eligible cohort.
• Patients with PAF had significantly longer QTc intervals (436 ms) compared to those without (417 ms).
• Each 10-ms QTc increase raised PAF risk (OR 1.41); an optimal threshold of 438 ms was identified (AUC 0.73).

Conclusions:

• QTc interval prolongation is a significant predictor of poststroke PAF.
• Measuring QTc may aid in identifying stroke patients at higher risk for PAF.
• This finding supports incorporating QTc assessment in post-stroke cardiac evaluations.