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01-09-2021 | Stroke | Original Article

Prevalence and predictors of atrial fibrillation in patients with embolic stroke of undetermined source: a real-life single-center retrospective study

Authors: Fabio Melis, Marilena Guido, Claudia Amellone, Marco Suppo, Maria Bonanno, Consuelo Bovio, Andrea Pessia, Katia Savio, Maria Teresa Lucciola, Elisa Ebrille, Giulia Guastamacchia, Daniela Cassano, Paola Filippi, Eva Milano, Massimo Giammaria, Daniele Imperiale

Published in: Neurological Sciences | Issue 9/2021

Abstract

Introduction

Up to one-third of ischemic strokes remained cryptogenic despite extensive investigations. Atrial fibrillation may be detected in a significant proportion of patients with embolic stroke of undetermined source, particularly after the introduction of implantable loop recorder in clinical practice.

Methods

We retrospectively included all the consecutive patients with embolic stroke of undetermined source referred to our units in the period November 2013 to December 2018 and in which an implantable loop recorder was positioned within 6 months from stroke event. Prevalence and predictors of atrial fibrillation were investigated.

Results

One hundred thirty-eight patients with embolic stroke of undetermined source fulfilling inclusion criteria were identified. The crude prevalence of atrial fibrillation at the end of observation period was of 45.7%. Incidence rates at 6, 12, 18, 24, and 36 months resulted, respectively, 31.8% (95% CI, 30.4–46.7), 38.0% (95% CI, 30.4–46.9), 42.6% (95% CI, 34.5–51.6), 46.6% (95% CI, 38.2–55.8), and 50.4% (95% CI, 41.6–59.9). On multivariate analysis, only excessive supraventricular electric activity and left atrial enlargement resulted to be significant predictors of atrial fibrillation (p = 0.037 and p < 0.0001, respectively).

Conclusions

Atrial fibrillation may be detected in a relevant proportion (up to 50%) of patients with embolic stroke of undetermined source if a careful and extensive diagnostic work-up is employed. Excessive supraventricular electric activity and left atrial enlargement are significant predictors of the occurrence of atrial fibrillation in these patients.

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Title: Prevalence and predictors of atrial fibrillation in patients with embolic stroke of undetermined source: a real-life single-center retrospective study
Authors: Fabio Melis
Marilena Guido
Claudia Amellone
Marco Suppo
Maria Bonanno
Consuelo Bovio
Andrea Pessia
Katia Savio
Maria Teresa Lucciola
Elisa Ebrille
Giulia Guastamacchia
Daniela Cassano
Paola Filippi
Eva Milano
Massimo Giammaria
Daniele Imperiale
Publication date: 01-09-2021
Publisher: Springer International Publishing
Keywords: Stroke
Atrial Fibrillation
Published in: Neurological Sciences / Issue 9/2021
Print ISSN: 1590-1874
Electronic ISSN: 1590-3478
DOI: https://doi.org/10.1007/s10072-020-04963-9

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Prevalence and predictors of atrial fibrillation in patients with embolic stroke of undetermined source: a real-life single-center retrospective study

Abstract

Introduction

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusions

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