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April 27, 2024International Journal of StrokeOpen Access

Temporal association between atrial fibrillation and ischemic stroke: Systematic review and meta-analysis

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Key result

Device-detected paroxysmal AF is linked to ~4-fold higher ischemic stroke risk within 30 days.

  • OR 4.11
  • 95% CI 1.03-16.40
  • n=4,041

Why the study?

Studies evaluating the temporal association between paroxysmal atrial fibrillation and ischemic stroke were inconclusive.

Is there a temporal association between paroxysmal atrial fibrillation episodes and ischemic stroke within 30 days in patients with continuous cardiac implantable electronic devices?

Population

4041 patients across 7 studies (138 with device-detected PAF episodes and stroke)

Comparison

Temporal association between AF episodes and stroke within 30 days vs 90 days

Design

Systematic review and meta-analysis

Authors

JDJessica D'LimaVTVincent ThijsHLH. Lim

Discussion

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Overview

Supports closer post-AF stroke monitoring in CIED patients; extends temporal association data but leaves optimal management open.

Study Design

Type

Meta-Analysis (n=4,041)

Structured PICO

Is there a temporal association between paroxysmal atrial fibrillation episodes and ischemic stroke within 30 days in patients with continuous cardiac implantable electronic devices?

P
Population
4041 patients from 7 studies with continuous cardiac implantable electronic devices (CIEDs), including 138 patients with device-detected paroxysmal atrial fibrillation (PAF) episodes and stroke.
I
Intervention
Paroxysmal atrial fibrillation (PAF) episodes detected by continuous cardiac implantable electronic devices (CIEDs)
C
Comparator
Periods without paroxysmal atrial fibrillation episodes
O
Outcome
Temporal association between AF episodes and ischemic stroke within 30 days of the arrhythmic episodehard clinical

Main Result

Effect estimate: OR 4.11 (95% CI 1.03-16.40)

This meta-analysis demonstrates a significant temporal relationship between paroxysmal atrial fibrillation and ischemic stroke within a 30-day window, highlighting the potential for individualized risk prediction and targeted anticoagulation.

Cite This Study

D'Lima et al. (2024) conducted a meta-analysis in Paroxysmal atrial fibrillation and ischemic stroke (n=4,041). Device-detected paroxysmal atrial fibrillation episodes was evaluated on Temporal association between AF episodes and stroke within 30 days of the arrhythmic episode (OR 4.11, 95% CI 1.03-16.40). Device-detected paroxysmal atrial fibrillation episodes were significantly associated with ischemic stroke within a 30-day window (OR 4.11; 95% CI 1.03-16.40).

synapsesocial.com/papers/6a0ef7d325c30b2cc7f9fbc8https://doi.org/10.1177/17474930241253482
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Temporal Association Between Episodes of Atrial Fibrillation and Risk of Ischemic Stroke2021 · 104 citations
  2. 2Ischemic Stroke Temporally Associated With New-Onset Atrial Fibrillation: A Population-Based Registry-Linkage Study2023 · 14 citations
  3. 3Atrial Fibrillation Burden and Short-Term Risk of Stroke2015 · 201 citations
  4. 4Cryptogenic ischemic stroke and prevalence of asymptomatic atrial fibrillation2014 · 33 citations
  5. 5Atrial Fibrillation in Patients with Embolic Stroke of Undetermined Source during 3 Years of Prolonged Monitoring with an Implantable Loop Recorder2021 · 47 citations