Do Restoring and Maintaining Sinus Rhythm Have a Beneficial Effect on Secondary Prevention of Stroke in Patients With Atrial Fibrillation? A Pilot Study

We aimed to determine whether attempts to restore and maintain sinus rhythm will reduce recurrent stroke in patients with atrial fibrillation (AF). Patients (n = 245) between March 1998 and May 2002 with AF who had an ischemic stroke including transient ischemic attack 1 to 12 months before transeso...

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Bibliographic Details
Published in:Angiology 2019-11, Vol.70 (10), p.916-920
Main Authors: Conkbayir, Cenk, Yigit, Zerrin, Hural, Refika, Ugurlucan, Murat, Oztas, Didem Melis, Okcun, Baris, Kucukoglu, Serdar
Format: Article
Language:English
Subjects:
Adult
Aged
Atrial Fibrillation - complications
Atrial Fibrillation - diagnosis
Echocardiography, Transesophageal - methods
Embolism - prevention & control
Female
Humans
Ischemic Attack, Transient - prevention & control
Male
Middle Aged
Pilot Projects
Secondary Prevention
Stroke - complications
Stroke - prevention & control
Treatment Outcome
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Summary:We aimed to determine whether attempts to restore and maintain sinus rhythm will reduce recurrent stroke in patients with atrial fibrillation (AF). Patients (n = 245) between March 1998 and May 2002 with AF who had an ischemic stroke including transient ischemic attack 1 to 12 months before transesophageal echocardiographic examination and had been followed for 3 years were retrospectively reviewed. Cardioversion was attempted in 130 patients; 117 (90%) patients were successfully cardioverted (rhythm control group). The 13 patients who could not be cardioverted and 115 patients who did not undergo cardioversion were assigned to the rate control group. Age, gender, ischemic heart disease, hypertension, diabetes mellitus, congestive heart failure, mitral valve disease, and left atrial diameter were similar in both groups. The rhythm control group included 56 patients (48.7%) who were still in sinus rhythm after 3 years. During follow-up, there were 2 embolic events (3.4%) and 2 deaths (3.4%) in the rhythm control group, whereas 18 embolic events (14.6%) and 18 deaths (14.6%) occurred in the rate control group (P = .049 and P = .049, respectively). Restoration and maintenance of sinus rhythm seems to have a beneficial effect on secondary prevention of stroke in patients with AF.
ISSN:0003-3197
1940-1574
DOI:10.1177/0003319719856455