High Atrial Ectopic Activity in Stroke: An Independent Risk Factor?

Background: High atrial ectopic burden has been associated with an increased risk of developing atrial fibrillation (AF) and more recently, an increased risk of ischaemic stroke beyond manifest AF. Methods: A single centre case control study was performed among patients with an ischaemic stroke/transient ischaemic attack (TIA), who had subsequent outpatient holter monitoring between May 2011 and May 2015. Premature atrial complex (PAC) burden and atrial runs ≥ 3 beats were documented and compared to a group of age and sex matched controls without prior stroke/TIA or AF at a 2:1 ratio. Results: 2804 patients that presented with an ischaemic stroke/TIA were included in the primary analysis, of which 300 stroke patients and 150 controls were included. The groups were well matched for age, risk factors and medication use at time of the index event. There was a trend to a higher mean PAC burden in the stroke patients (569 vs 295 p= 0.13), although no significant difference was noted in the number of atrial runs (10 vs 6; p=0.40) between the groups. Conclusions: Patients presenting with stroke/TIA have a trend towards an increased PAC burden compared with an age-matched control population. Further studies are required to confirm and define the clinical significance of these findings.Tabled 1BaselineStrokeN= 300ControlN=150P valueAF on holter5.7%0%0.03Total PAC/24 hours5692950.13Total no: of runs1060.40Total no: of beats in runs42370.77 Open table in a new tab