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Updated: Dec 5, 2025
Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
Published on: January 18, 2018
Influence of atrial fibrillation detection time on outcome after endovascular thrombectomy
R R Leker1, A Farraj1, A Filioglo1
1Departments of Neurology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
Insights
For patients with large vessel occlusions (LVO) treated with endovascular thrombectomy (EVT), the timing of atrial fibrillation (AF) diagnosis does not impact stroke outcomes. Whether AF was newly diagnosed or known prior to stroke, EVT results were similar.
Area of Science:
- Neurology
- Cardiology
- Interventional Radiology
Background:
- Atrial fibrillation (AF) is a common cause of cardioembolic stroke leading to large vessel occlusions (LVO).
- Endovascular thrombectomy (EVT) is a critical treatment for restoring cerebral blood flow in LVO.
- The impact of newly diagnosed AF versus previously known AF on stroke outcomes after EVT is not well understood.
Purpose of the Study:
- To investigate whether the timing of atrial fibrillation (AF) diagnosis influences outcomes in patients with LVO undergoing EVT.
- To compare outcomes between patients with newly diagnosed AF (newAF) and those with pre-existing AF (kAF) after stroke.
Main Methods:
- Retrospective analysis of consecutive LVO patients treated with EVT.
- Comparison of clinical characteristics and outcomes between newAF, kAF, and no-AF groups.
- Multivariate analysis to assess the influence of AF diagnosis timing on survival, recanalization, and functional outcome.
Main Results:
- Of 230 patients, 109 (47%) had AF (86 kAF, 23 newAF).
- Patients with kAF had a higher rate of prior strokes than newAF patients (20% vs. 4%, p=0.04).
- Multivariate analysis showed no significant difference in survival (OR 0.89), favorable recanalization (OR 1.2), or favorable outcome (OR 1.32) based on AF diagnosis timing.
Conclusions:
- The timing of atrial fibrillation diagnosis does not appear to affect outcomes in patients with LVO undergoing EVT.
- Both newAF and kAF groups had older age, better recanalization rates, and poorer outcomes compared to the no-AF group.
- This suggests that regardless of when AF is detected, EVT remains a viable treatment for LVO in these patients.
Background:
Cardiac emboli secondary to atrial fibrillation (AF) commonly cause large vessel occlusions (LVO) that require endovascular thrombectomy (EVT) to restore cerebral circulation. Whether the outcome of patients with AF diagnosed after the index stroke (newAF) differs from that of AF-patients in which AF was known before stroke (kAF) remains unknown.
Patients And Methods:
Consecutive LVO patients treated with EVT were recruited and the data was analyzed retrospectively. We compared patients with newAF to those with kAF and those without AF.
Results:
Among 230 patients included, 109 (47%) had AF (86 kAF, 23 newAF). Patients with kAF more often had prior strokes compared with those with newAF (20% vs. 4% p = 0.04) but other parameters did not differ between the groups. Both AF groups were significantly older, more often reached favorable recanalization and less often had favorable outcomes compared to those without AF. On multivariate analyses, timing of AF detection did not influence survival (Odds Ration [OR] 0.89 95% Confidence Interval [CI] 0.28-1.90), chances for favorable recanalization (OR 1.2 95% CI 0.44-3.26) or favorable outcome 1.32 (95% CI 0.57-3.05).
Conclusions:
Timing of AF diagnosis does not appear to influence outcome in patients with LVO that underwent EVT.
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