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. 2016 Feb 19:5:130.
doi: 10.1186/s40064-016-1756-x. eCollection 2016.

Cryptogenic ischemic stroke and silent atrial fibrillation: What is the relationship?

Mustafa Karaca  1 , D Aytekin  2 , T Kırıs  1 , A Koskderelioglu  3 , M Gedizlioglu  3
Affiliations

Cryptogenic ischemic stroke and silent atrial fibrillation: What is the relationship?

Mustafa Karaca et al. Springerplus. .

Abstract

Atrial fibrillation (AF) is responsible for up to one-third of ischemic strokes and associated with silent cerebral infarctions and transient ischemic attacks. Any method that predicts the stroke or unmasks the silent PAF would contribute to the treatment of ischemic stroke. Intraatrial conduction time (ICT) has been shown to be associated with intermittent AF. In this study, we evaluated the value of ICT detected by transthoracic echocardiography in normal population and in patients with cryptogenic stroke (CS) as a risk factor for stroke. The patients with CS and with normal left ventricular function without valvular disease are included in group 1. Patients with atypical symptoms admitted to cardiology clinics without any risk factor for cardiac disease and found to be normal constituted group 2. Age, gender, weight, height, echocardiographic parameters and ICT were compared between groups. 63 and 64 subjects were included in group 1 and 2, respectively. Two groups were similar according to age and gender. Among the parameters studied, left atrial diameter and height of the patients were significantly higher in group 1 (40 ± 2 vs 37 ± 4 mm, p < 0.001 and 167 ± 9 vs 163 ± 9 cm p = 0.027, respectively). ICT was significantly higher in group 1 (131 ± 15 vs 118 ± 13 ms, respectively, p < 0.000). According to ROC analysis, a cut point of 124 ms for ICT with a sensitivity of 74 % and specificity of 73 % in patients with CS (p < 0.001). This study show us, the measurements the ICT determined by means of echocardiography is longer in patients with CS. This simple and noninvasive technique can be applied widely and lead the clinicians to adopt the use of diagnostic and the treatment procedures.

Keywords: Atrial fibrillation; Cryptogenic stroke; Echocardiography; Intraatrial conduction time.

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Figures

Fig. 1
Fig. 1
Receiver operating curve of intraatrial conduction time for cryptogenic stroke
Fig. 2
Fig. 2
Intraatrial conduction time is defined as the time between the beginning of the p wave in surface ECG and the top of the A wave recorded from the tissue Doppler imaging from the left atrial free wall next to the mitral annulus
See this image and copyright information in PMC

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