Key result
Chronic atrial fibrillation increases stroke incidence by over fivefold in the absence of rheumatic heart disease and 17-fold with RHD over a 24-year follow-up.
Why the study?
Does chronic atrial fibrillation increase the risk of stroke in the general population?
Does chronic atrial fibrillation increase the risk of stroke in the general population?
Chronic atrial fibrillation is a major precursor to stroke, significantly increasing stroke incidence regardless of the presence of rheumatic heart disease.
Answers are grounded in this paper and cite their sources.
AF markedly elevates long-term stroke risk, especially with RHD; extends prior observations but leaves causal and therapeutic implications open.
Chronic atrial fibrillation (AF) as a precursor of stroke was assessed over 24 years of follow-up of the general population sample at Framingham, Massachusetts. Persons with chronic established AF, with or without rheumatic heart disease (RHD), are at greatly increased risk of stroke, and the stroke is probably due to embolism. Chronic AF in the absence of RHD is associated with more than a fivefold increase in stroke indicence, while AF with RHD has a 17-fold increase. Stroke occurrence increased as duration of AF increased, with no evidence of a particularly vulnerable period. Chronic idiopathic AF is an important precursor of cerebral embolism. Controlled trials of anticoagulants or antiarrhythmic agents in persons with chronic AF may demonstrate if strokes can be prevented in this highly susceptible group.
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Wolf et al. (1978) studied this question. Chronic atrial fibrillation increases stroke incidence by over fivefold in the absence of rheumatic heart disease and 17-fold with RHD over a 24-year follow-up.
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