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Published on: February 26, 2013
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Risk Factors and Outcomes Associated with Atrial Fibrillation Detected after Intracerebral Hemorrhage
Farid Khasiyev1,2, Karin Oh1, Angela Velazquez1
1Department of Neurology, Columbia University Irving Medical Center, 177 Fort Washington Ave., New York, NY, 10032, USA.
Neurocritical Care
|March 18, 2026
Summary
Atrial fibrillation detected after stroke (AFDAS) in intracerebral hemorrhage (ICH) patients is linked to worse long-term outcomes, despite fewer baseline cardiovascular issues. Early detection and prevention strategies are needed.
Area of Science:
- Neurology
- Cardiology
- Clinical Research
Background:
- Atrial fibrillation detected after stroke (AFDAS) is common after ischemic stroke but poorly understood in intracerebral hemorrhage (ICH).
- Investigating AFDAS in ICH is crucial for understanding its occurrence and clinical impact.
- This study characterizes risk factors and long-term outcomes associated with AFDAS in ICH patients.
Purpose of the Study:
- To determine the incidence and risk factors of AFDAS in patients with spontaneous ICH.
- To evaluate the association between AFDAS and long-term outcomes in ICH survivors.
- To compare clinical characteristics and comorbidities between ICH patients with AFDAS, known AF, and sinus rhythm.
Main Methods:
- Retrospective analysis of 532 consecutive spontaneous ICH patients from 2009-2018 with continuous cardiac monitoring.
- Patients classified into sinus rhythm (SR), AFDAS (AF detected during index ICH hospitalization), and known AF groups.
- Primary outcome: poor modified Rankin scale (mRS 4-6) at 3 months; multivariable logistic regression used for analysis.
Main Results:
- AFDAS occurred in 5% of ICH patients, typically by hospital day 3.
- AFDAS patients had fewer baseline cardiovascular comorbidities but higher rates of infectious complications during hospitalization.
- Poor 3-month outcomes were significantly more common in AFDAS patients (94%) compared to known AF (78%) and SR (65%) groups.
- AFDAS was independently associated with poor long-term outcomes (aOR 11.07, 95% CI 1.30-94.27).
Conclusions:
- ICH patients with AFDAS exhibit a distinct profile with fewer baseline cardiovascular comorbidities but worse long-term prognoses.
- Further research is needed to elucidate the drivers of AFDAS and its direct link to poor ICH outcomes.
- Prospective studies are essential to confirm findings and explore the potential benefits of AFDAS detection and prevention in improving ICH outcomes.
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