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Europace Advance Access originally published online on March 14, 2009
Europace 2009 11(5):582-586; doi:10.1093/europace/eup062
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2009. For permissions please email: journals.permissions@oxfordjournals.org

Stroke in Atrial Fibrillation

Atrial fibrillatory rate and risk of stroke in atrial fibrillation

Andreas Bollmann1,2,*, Daniela Husser1,2, Arne Lindgren3, Martin Stridh4, Bjarne Madsen Härdig1, Christopher Piorkowski2, Arash Arya2, Leif Sörnmo4 and S. Bertil Olsson1

1 Department of Cardiology, Lund University, Lund, Sweden; 2 Department of Electrophysiology, Heart Center, Leipzig University, Leipzig, Germany; 3 Department of Neurology, Lund University, Lund, Sweden; 4 Department of Electroscience, Lund University, Lund, Sweden

Aims: In atrial fibrillation (AF), a relation between electrocardiogram (ECG) parameters such as fibrillatory wave amplitude and stroke has been sought with conflicting results. In this study, we tested the hypothesis that the atrial fibrillatory rate of surface ECG lead V1 is related to stroke risk and may consequently be helpful for identifying high-risk patients.

Methods and results: Atrial fibrillatory rate of 79 consecutive patients with AF and embolic stroke (age 83 ± 7 years, 41% male) was compared with those of a matched AF population without stroke (n = 79). Atrial fibrillatory rate was determined from the surface ECG using spatiotemporal QRST cancellation and time–frequency analysis of lead V1. There was no significant difference in any clinical or echocardiographic variable in patients with stroke compared with AF controls without stroke. Atrial fibrillatory rate measured 373 ± 55 fibrillations per minute (fpm; range 235–505 fpm) in the entire population. There was no fibrillatory rate difference between stroke patients (369 ± 54 fpm, range 256–505 fpm) and AF controls without stroke (378 ± 56 fpm, range 235–488 fpm). There was an inverse correlation between fibrillatory rate and age (R = –0.219, P = 0.006). Individuals aged ≥85 years had a significantly lower fibrillatory rate (356 ± 44 fpm) than individuals aged 65–74 years (384 ± 56 fpm, P = 0.033) and individuals aged 75–84 years (384 ± 60 fpm, P = 0.016). In those subgroups, fibrillatory rates were, however, also similar in stroke patients and AF controls.

Conclusion: Atrial fibrillatory rate obtained from surface ECG lead V1 is not a risk marker for stroke in AF.

Key Words: Atrial fibrillation, Electrocardiography, Stroke

* Corresponding author. Tel: +49 341 865 1413, Fax: +49 341 865 1460. Email: andreas.bollmann{at}med.lu.se

Manuscript submitted 9 December 2008. Accepted after revision 17 February 2009.


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