Echocardiographic Parameters for Predicting Atrial Fibrillation Following Ischemic Stroke: The PER DIEM...

Area of Science:

• Cardiology
• Neurology
• Medical Imaging

Background:

• Atrial fibrillation (AF) detection post-ischemic stroke is crucial for patient management.
• Echocardiography (echo) is frequently performed after stroke and can identify patients for rhythm monitoring.
• The PER DIEM trial showed implantable loop recorders (ILRs) detect AF more effectively than external monitors.

Purpose of the Study:

• To investigate the association between baseline echocardiographic parameters and the detection of poststroke AF.
• To identify specific echo features that predict AF in patients following an ischemic stroke.

Main Methods:

• A substudy of the PER DIEM trial included patients with complete transthoracic echocardiograms post-ischemic stroke.
• Demographic, clinical, and echocardiographic data were collected and compared between patients with and without AF.
• Statistical analyses were performed to determine associations between echo parameters and AF detection.

Main Results:

• Poststroke AF was detected in 12.4% of the 153 patients studied.
• Patients with AF were older and had higher CHA2DS2-VASc scores.
• Higher left atrial volume index (LAVI) and lower left ventricular global longitudinal strain (LV GLS) were significantly associated with AF detection.

Conclusions:

• Left atrial volume index and LV GLS are significantly associated with subsequent AF detection in ischemic stroke patients.
• These echocardiographic findings can aid in risk stratification for AF monitoring strategies.
• Improved AF detection can lead to more targeted management following ischemic stroke.