Short-Run Atrial Tachyarrhythmia Associated With Increased Stroke Risk

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Older age and premature atrial contractions were independent predictors for stroke risk in patients who had CHA2DS2-VASc scores of 0 or 1. <i>Photo Credit: Scott Camazine/Medical Images</i>
Older age and premature atrial contractions were independent predictors for stroke risk in patients who had CHA2DS2-VASc scores of 0 or 1. Photo Credit: Scott Camazine/Medical Images

Short-run atrial tachyarrhythmia (AT), older age, high CHA2DS2-VASc scores, and premature atrial contractions >25 beats/d are associated with increased risks for new-onset stroke, according to findings from a retrospective review published in Stroke.

Using the Registry of 24-hour Electrocardiographic Monitoring at Taipei Veterans General Hospital in Taiwan, the investigators evaluated patients without atrial fibrillation (AF) or a history of stroke (N=5342). Of these patients, 29.8% (n=1595) had short-run AT defined as supraventricular ectopic beats <5 seconds. A total of 494 patients developed new-onset stroke during the median 9-year follow-up period.

Compared with patients without short-run AT, patients who had short-run AT experienced significantly higher rates of stroke (8.3% vs 11.4%, respectively; P <.001). 

In patients with short-run AT with CHA2DS2-VASc scores of 0, 1, 2, 3, 4, and ≥5, the number of strokes per 100 person-years was 0.23, 0.67, 1.62, 1.89, 1.30, and 2.91, respectively. Being older than 61 years of age and having premature atrial contractions >25 beats/d were independent predictors of stroke risk in patients who had CHA2DS2-VASc scores of 0 or 1.

In addition, an intermediate CHA2DS2-VASc score (1 [men] or 2 [women]) or a high CHA2DS2-VASc score (≥2 [men] or ≥3 [women]) was independently associated with a higher risk for stroke (hazard ratio [HR], 6.165; P <.001 and HR, 8.577; P <.001, respectively) compared with patients with a low score (0 [men] or 1 [women]) in short-run AT.

 

In this study, the researchers were unable to adjust for interactions between stroke and the potential use of additional antithrombotic therapy, limiting the findings.

Overall, the results offer clinically “useful information for the management of patients with short-run AT.”

Reference

Yamada S, Lin CY, Chang SL, et al. Risk of stroke in patients with short-run atrial tachyarrhythmia [published online November 16, 2017]. Stroke. doi:10.1161/STROKEAHA.117.018475

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