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Paroxysmal Atrial Fibrillation in Cryptogenic Stroke Patients With Major-Vessel Occlusion

Ryosuke Doijiri1, Hiroshi Yamagami2,3, Masafumi Morimoto4

  • 1Department of Neurology, Iwate Prefectural Central Hospital, Morioka, Japan.

Frontiers in Neurology
|December 7, 2020
PubMed

Insights

Acute major-vessel occlusion (MVO) in cryptogenic stroke patients predicts atrial fibrillation (AF) detection by insertable cardiac monitoring. This finding highlights MVO as a key indicator for latent AF screening in stroke patients.

Area of Science:

  • Neurology
  • Cardiology
  • Medical Diagnostics

Background:

  • Cryptogenic stroke (CS) represents a significant portion of all ischemic strokes.
  • Identifying the etiology of CS, particularly atrial fibrillation (AF), is crucial for secondary prevention.
  • Insertable cardiac monitoring (ICM) has improved the detection of subclinical arrhythmias like AF.

Purpose of the Study:

  • To investigate the association between acute major-vessel occlusion (MVO) and the detection of AF in patients with CS.
  • To determine if MVO can serve as a predictor for latent AF in the CS population.

Main Methods:

  • Retrospective, multicenter, observational study design.
  • Inclusion of 84 consecutive CS patients who underwent ICM implantation.
  • Analysis of ICM data for AF detection within 90 days, correlated with MVO status.

Main Results:

  • Newly detected AF by ICM was significantly higher in patients with MVO (41%) compared to those without MVO (13%).
  • Major-vessel occlusion (MVO) was independently associated with AF detection after adjusting for relevant clinical factors.
  • The observed association remained significant within 90 days of ICM implantation.

Conclusions:

  • Acute major-vessel occlusion (MVO) is an independent predictor of atrial fibrillation (AF) detection in cryptogenic stroke patients.
  • MVO may serve as a valuable clinical marker to identify CS patients at higher risk for latent AF.
  • Active screening for latent AF is recommended for CS patients presenting with MVO to guide appropriate management and prevent recurrent events.
Keywords:
cryptogenic strokeinsertable cardiac monitorsmajor-vessel occlusionparoxysmal atrial fibrillationstroke recurrence

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