Abstract WP258: Is it Time to Stop Playing Hide-And-Seek With Atrial Fibrillation After Endovascular Treatment?

Abstract

Background: The etiology of stroke remains unknown over 25% of cases. Stroke with Large Vessel Occlusion (LVO) treated with endovascular treatment (EVT) and complete recanalization are a good group to analyze efficiency of diagnosis studies. After hospitalization the percentage and clinical impact of hidden atrial fibrillation (AF) diagnosis in embolic strokes of unknown source are uncertain. Methods: We reviewed patients treated with EVT from 2010 to 2016. We evaluated percentage of cases with new clinical diagnosis of atrial fibrillation during long-term follow-up in several etiologic subgroups. We analyze several epidemiologic variables, functional recovery and other relevant pathologies. Results: A total of 514 patients with complete cardiac diagnosis tests treated with EVT were analyzed over 3,9 years of follow-up. The etiology of stroke was unknown in 123 patients (23,9%). During follow-up were diagnosed 8% of patients with new atrial fibrillation/flutter in unknown etiology subgroup (3% in atherothrombotic and none in unusual subgroup). Half of them presented minor cardiologic symptoms but none of them had presented a new stroke. Variables significant associated to new finding of AF were >6 supraventricular extrasystoles or tachycardia in 24Holter test and severe auricular dilatation evaluated by means echocardiography during hospitalization (p:0.004). Only 2% patients were studied with long-term heart rhythm recorder. Other new diagnoses in follow-up of EVT were malignant neoplasm (7%) and delayed seizures (6%). Conclusions: The findings of atrial fibrillation in follow-up of patients treated with EVT with complete cardiac diagnosis tests are infrequent. The recurrence of stroke seems rare in follow-up, however we must select patients for catch atrial fibrillation by means long-term heart recorder systems according to signs of auricular impairment.