Frequent premature atrial contractions in stroke of undetermined etiology

Eur Neurol. 2009;61(5):285-8. doi: 10.1159/000206853. Epub 2009 Mar 17.


Background: The cause of ischemic stroke is undetermined in 15-40% of patients. We studied the association between frequent premature atrial contractions (PAC) and stroke of undetermined etiology.

Methods: We retrospectively studied ischemic stroke patients who were consecutively admitted to our department and underwent 24-hour Holter ECG recording including 163 noncardioembolic stroke patients (group A), 24 stroke patients of undetermined etiology (group B), and 37 cardioembolic stroke patients with prior-diagnosed paroxysmal atrial fibrillation (group C). The number of PAC per 24 h and the prevalence of patients with frequent PAC (200 or more per 24 h) were compared between the groups.

Results: The number of PAC was significantly larger in groups B and C than in group A. The proportion of patients with frequent PAC was larger in group B (13/24, 54%) and in group C (18/37, 48%) than in group A (32/163, 20%).

Conclusion: Our data suggest that frequent PAC should be regarded as a masked type of paroxysmal atrial fibrillation and should be included in one of the causes of cardioembolic stroke.

MeSH terms

  • Aged
  • Atrial Function / physiology*
  • Atrial Premature Complexes / complications*
  • Atrial Premature Complexes / physiopathology
  • Brain Ischemia / etiology*
  • Electrocardiography
  • Female
  • Heart Atria / physiopathology
  • Humans
  • Male
  • Myocardial Contraction
  • Retrospective Studies
  • Risk Factors
  • Stroke / etiology*