CIED research highlights the close relationship between AFib and ischemic stroke
Continuous heart rhythm monitoring can identify when patients face a higher risk of atrial fibrillation (AFib) or ischemic stroke, according to a new analysis published in JAMA Cardiology.
The authors examined data from more than 466,000 patients from two different large databases, and 891 of those patients were wearing a Medtronic cardiovascular implantable electronic device (CIED) when they experienced an ischemic stroke. CIED data from 120 days prior to each patient’s stroke was also available, allowing researchers to look for key patterns or shifts in outcomes.
While 64.5% of those 891 patients were male, the average age was 76 years old. Also, the CIED findings of 7.4% of those patients included “informative, discordant” rhythm patterns.
Overall, researchers noted, AFib episodes that lasted 5.5 hours or longer were associated with raising a patient’s risk of ischemic stroke within the next 30 days by a significant margin. A patient’s stroke risk was highest within five days of experiencing an AFib episode that lasted 5.5 hours or longer; that risk decreased as more time went on.
Among patients on oral anticoagulants, the authors added, there was no “temporal association” between AFib and stroke.
“Overall, these findings significantly underscore traditional thinking that AF is likely a causal risk factor for ischemic stroke as opposed to just a risk marker,” lead author Daniel Singer, MD, professor of medicine at Harvard Medical School and a specialist at Massachusetts General Hospital, said in a prepared statement from Medtronic. “The results indicate that prolonged episodes of AF increase stroke risk, but this risk decreases rapidly following the end of the episode. These findings raise the possibility that time-limited anticoagulation for infrequent episodes of AF may be an effective stroke prevention strategy.”
The full JAMA Cardiology study is available here.