[Ischemic stroke in elderly patients with paroxysmal atrial fibrillation]

We compared the rate of ischemic strokes in elderly patients (those aged 65 years or more) who had paroxysmal atrial fibrillation (E-PAf) with those of younger patients (less than 65) with paroxysmal atrial fibrillation (Y-PAf) and of elderly patients with chronic atrial fibrillation (E-CAf) in a retrospective study. A total of 95 E-PAf patients (mean age 73.6), 79 Y-PAf patients (mean age 52.4), and 95 E-CAf patients (mean age 73.6) were studied. The incidence of all ischemic strokes in E-PAf patients (4.8%/yr) was significantly lower than in E-CAf patients (8.3%/yr) and higher than in Y-PAf patients (2.5%/yr) (p < .01). We found the same tendency in the occurrence of brain embolism. Brain embolism occurred in 2.7% of E-PAf patients per year which was significantly lower than in E-CAf patients (5.1%/yr) and higher than in Y-PAf patients (1.3%/yr) (p < .01). E-PAf patients suffered more brain thrombosis than Y-PAf patients, but they had nearly the same incidence as did E-CAf patients. Fifty-seven E-PAf patients had only one attack of atrial fibrillation and the remaining 38 had more than two attacks. Patients with many attacks of atrial fibrillation had significantly higher rate of brain embolism than did those who had only one attack (4.6 v.s. 0.8%/yr) (p < .005). Those two groups did not differ with regard to the rate of brain thrombosis.