disease interaction(s) of atrial fibrillation with ischemic stroke
Jump to navigation
Jump to search
Diagnostic procedures
- after ischemic stroke, implantable electrocardiographic monitoring for 12 months results in detection of more atrial fibrillation* (15%) vs external monitoring for 30 days (4.7%)[2]
- after large or small vessel ischemic stroke
- implantable electrocardiographic monitoring for 12 months results in detection of more atrial fibrillation (12.1%) vs usual care (1.8%)[3]
* atrial fibrillation or atrial flutter lasting > 2 minutes
Complications
- patients with atrial fibrillation diagnosed only after an ischemic stroke at lower risk for recurrent stroke than patients with atrial fibrillation diagnosed before the index stroke
Management
- start of direct oral anticoagulant after ischemic stroke in patients with atrial fibrillation within 4 days with similar outcomes to start in 5-10 days[5]
More general terms
References
- ↑ Sposato LA, Cerasuolo JO, Cipriano LE et al. Atrial fibrillation detected after stroke is related to a low risk of ischemic stroke recurrence. Neurology 2018 Mar 13; 90:e924 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/29444969 <Internet> http://n.neurology.org/content/90/11/e924
- ↑ 2.0 2.1 Buck BH, Hill MD, Quinn FR et al Effect of Implantable vs Prolonged External Electrocardiographic Monitoring on Atrial Fibrillation Detection in Patients With Ischemic Stroke. The PER DIEM Randomized Clinical Trial. JAMA. 2021;325(21):2160-2168 PMID: https://www.ncbi.nlm.nih.gov/pubmed/34061146 https://jamanetwork.com/journals/jama/fullarticle/2780491
Tirschwell D, Akoum N. Detection of Subclinical Atrial Fibrillation After Stroke. Is There Enough Evidence to Treat? JAMA. 2021;325(21):2157-2159 PMID: https://www.ncbi.nlm.nih.gov/pubmed/34061158 https://jamanetwork.com/journals/jama/fullarticle/2780508 - ↑ 3.0 3.1 Bernstein RA, Kamel H, Granger CB et al Effect of Long-term Continuous Cardiac Monitoring vs Usual Care on Detection of Atrial Fibrillation in Patients With Stroke Attributed to Large- or Small- Vessel Disease. The STROKE-AF Randomized Clinical Trial. JAMA 2021. Jun 1;325(21):2169-2177 PMID: https://www.ncbi.nlm.nih.gov/pubmed/34061145 https://jamanetwork.com/journals/jama/fullarticle/2780490
- ↑ Hughes S Evidence Mounts for Implantable AF Monitoring After Stroke. Medscape - Jun 02, 2021. https://www.medscape.com/viewarticle/952325
- ↑ 5.0 5.1 Oldgren J et al. Early versus delayed non-vitamin K antagonist oral anticoagulant therapy after acute ischemic stroke in atrial fibrillation (TIMING): A registry-based randomized controlled noninferiority study. Circulation 2022 Sep 6; [e-pub]. PMID: https://www.ncbi.nlm.nih.gov/pubmed/36065821 https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.122.060666