Does the presence of atrial fibrillation alter the clinical presentation and symptoms in patients with left hemispheric transient ischemic attack?
TIA patients with atrial fibrillation are significantly more likely to present with major hemispheric syndromes such as aphasia compared to those without AF.
OBJECTIVE: The aim of this study was to clarify the characteristics of transient ischemic attack (TIA) patients with atrial fibrillation (AF) compared to those without. METHODS: We divided 67 TIA patients with left hemispheric involvement into two groups; patients with AF (AF group) and without AF (Non-AF group) and compared the clinical characteristics between the two groups. PATIENTS: AF group included 12 patients (73.0 +/- 9.7 years old) and the Non-AF group 55 patients (64.1 +/- 9.8 years old). RESULTS: Clinically, arterial disease was less frequently seen in the AF group than in the Non-AF group (17% vs 53%, p = 0.028). No significant differences were observed between the two groups in the duration (< 1 hour; AF vs Non AF group: 50% vs 32%) or number of TIAs (more than 1; 17% vs 37%), use of anticoagulation or antiplatelet at time of symptom onset (34% vs 14%), past history of stroke and TIA (58% vs 38%) and ischemic heart diseases (8% vs 13%), and risk factors for atherosclerosis including hypertension (42% vs 71%), diabetes mellitus (17% vs 31%), hyperlipidemia (17% vs 47%), smoking (50% vs 51%) and other emboligenic cardiac diseases except for AF (0% vs 4%). Aphasia was observed more frequently in the AF group than in the Non-AF group (67% vs 20%, p = 0.003), whereas, hemiparesis without aphasia was seen less frequently in the AF group than in the Non-AF group (17% vs 55%, p = 0.025). CONCLUSION: TIA patients with AF are more likely than those without AF to exhibit a major hemispheric syndrome, such as aphasia.
KlMURA et al. (2003) studied this question.