Abstract T P174: Stroke Severity in Patients With Different Durations of Atrial Fibrillation
Background: Persistent atrial fibrillation (AF) is a common risk factor for stroke. Strokes caused by AF are usually more severe as compared to stroke in patients without AF. Recent evidence suggests that stroke risk in paroxysmal AF is similar to persistent AF, but which minimal duration of AF already increases stroke risk, is unknown. We aimed to compare stroke severity in stroke patients with different durations of AF.
Methods: 272 stroke patients were prospectively included. 43 had AF on admission (persistent AF). During 7-day-Holter-ECG, an additional 29 patients were diagnosed with AF of at least 30 seconds (paroxysmal AF). 200 patients had no AF > 30 seconds. Of these, 72 had supraventricular runs of at least 10 beats during 24h-Holter ECG. Stroke severity was characterised by NIH stroke scale (NIHSS) and modified Rankin scale (mRS). All values are given as median (25%/75%) and compared by Mann-Whitney-U-Test.
Results: NIHSS and mRS values were similar in patients with persistent and paroxysmal AF (see table: p=0.239 (NIHSS), p=0.623 (mRS), respectively. In patients with no AF, NIHSS: 2 (1-4) and mRS: 2 (1-3) were significantly lower as compared to patients with paroxysmal AF (NIHSS: p <0.001; mRS: p=0.034).
NIHSS and mRS did not differ in patients with short episodes of paroxysmal AF (6 minutes or shorter) as compared to patients with medium duration of episodes (6 minutes to 6 hours) or long episodes > 6 hours.
In patients with no AF, the presence of supraventricular runs of at least 10 beats was not associated with higher NIHSS or mRS as compared to patients without supraventricular runs (p=0.239 and p=0.621, respectively).
Conclusion: Our results suggests that patients with paroxysmal AF of at least 30 seconds during 7-day-Holter have strokes similar to patients with persistent AF. Whether these patients benefit similarly to persistent AF patients from anticoagulation for secondary stroke prevention, should be investigated in further prospective randomised trials.
Author Disclosures: R. Wachter: Research Grant; Significant; Boehringer Ingelheim, Medtronic. M. Weber-Krueger: None. R. Stahrenberg: None. J. Seegers: None. K. Gröschel: None.
- © 2014 by American Heart Association, Inc.