Abstract
Background: Emerging evidence suggests that underlying atrial cardiopathy (AC) may result in thromboembolism formation in the absence of atrial fibrillation (AF). This may explain a proportion of large vessel occlusion (LVO) cryptogenic strokes. The prevalence of AC in endovascular thrombectomy (EVT) patients has not been assessed. Methods: A prospectively maintained database of EVT patients treated at a comprehensive stroke centres between January 2016 and September 2018 was retrospectively screened. Patients undergoing EVT for acute ischemic stroke with admission electrocardiogram (ECG) were selected. Subjects were screened for AF, paroxysmal AF (pAF) and AC with previously validated ECG markers (P-wave terminal force in lead V1 - PTFV1 >4000μV/ms & prolonged P-wave duration - PWD >120 ms. Results: A total of 189 patients were included. Atrial fibrillation was present in 73 (38.6%) patients. Paroxysmal AF was recorded in 31 (16.4%) patients. Atrial cardiopathy markers were present in 88 (46.6%) of the total cohort, compared to 7.7% in a published general population reference (p < 0.001). Atrial cardiopathy was present in 23 (74%) of pAF patients. Conclusion: Atrial cardiopathy occurs frequently in EVT patients, suggesting it may be a LVO stroke risk factor. Atrial cardiopathy may be associated with pAF. Further studies in this patient population are recommended.
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