[Anomalties of the interatrial septum and latent atrial vulnerability in unexplained ischemic stroke in young adults]

Abstract

Seventy-four consecutive patients (18 to 55 years) underwent programmed atrial stimulation in the investigation of unexplained ischaemic stroke after a full work-up including transoesophageal echocardiography to exclude abnormalities of the interatrial septum (patent foramen ovale and/or atrial septal aneurysm). The parameters recorded during atrial electrophysiological investigation were: the effective atrial refractory period, loco-regional intra-atrial conduction, the index of latent atrial vulnerability and the inducibility by the extrastimulus technique. Seventy five per cent of patients with a patent foramen ovale and/or an atrial septal aneurysm were inducible compared with only 38% of patients with normal interatrial septa on transoesophageal echocardiography (p = 0.001). Fifty two per cent of patients with an anomaly of the atrial septum had latent atrial vulnerability compared with 26% of those with normal transoesophageal echocardiography (p = 0.02). These results confirm the relationship between atrial septal anomalies and latent atrial vulnerability in unexplained ischaemic stroke of young adults.