Lower left atrial appendage peak emptying velocity after cryptogenic stroke was independently associated with new-onset atrial fibrillation (HR 0.93; 95% CI 0.88-0.99; P=0.016).
Observational (n=73)
Does a lower left atrial appendage peak emptying velocity predict new-onset atrial fibrillation in patients with cryptogenic stroke?
A lower left atrial appendage peak emptying velocity (≤ 46.5 cm/s) on TEE after cryptogenic stroke predicts future occurrence of atrial fibrillation and the combined endpoint of death or ischemic stroke.
Effect estimate: HR 0.93 (95% CI 0.88-0.99)
p-value: p=.016
BACKGROUND: Silent atrial fibrillation is a frequent etiology of cryptogenic stroke. Spontaneous conversion of atrial fibrillation to sinus rhythm results in atrial stunning. OBJECTIVE: To evaluate if the presence of a lower left atrial appendage peak emptying velocity (LAAV) after a cryptogenic stroke is associated with the occurrence of atrial fibrillation (AF). METHODS: We retrospectively selected consecutive patients with an acute ischemic stroke that had a transoesophageal echocardiogram (TEE) performed in the first 30 days of the acute event. Documented AF or potential cardioembolic sources in the TEE were considered exclusion criteria. We assessed the LAAV. During follow-up, we evaluated the occurrence of new-onset AF and the combined endpoint of death or new ischemic stroke. RESULTS: We studied 73 consecutive patients, during a mean follow-up period of 54.9 ± 19.3 months. Seven developed AF, and 13 had the combined endpoint. LAAV was independently associated with AF occurrence (HR: 0.93, 95% CI: 0.88-0.99; P = .016). Patients with a LAAV ≤ 46.5 cm/s (AUC: 0.766, 95% CI: 0.579-0.954; P = .021) had a lower survival rate free from AF occurrence (Log-rank, P < .001) and free from the combined endpoint of death or ischemic stroke (Log-rank, P = .010). CONCLUSION: A lower LAAV was associated with AF occurrence and the combined endpoint of death or ischemic stroke after an initial episode of cryptogenic stroke. Patients with this finding could eventually benefit from long-term cardiac rhythm monitoring.
Farinha et al. (Tue,) conducted a observational in Cryptogenic stroke (n=73). Lower left atrial appendage peak emptying velocity (LAAV) vs. Higher LAAV was evaluated on Occurrence of new-onset atrial fibrillation (HR 0.93, 95% CI 0.88-0.99, p=.016). Lower left atrial appendage peak emptying velocity after cryptogenic stroke was independently associated with new-onset atrial fibrillation (HR 0.93; 95% CI 0.88-0.99; P=0.016).