Influence of atrial fibrillation detection time on outcome after endovascular thrombectomy

J Neurol Sci. 2020 Dec 15:419:117189. doi: 10.1016/j.jns.2020.117189. Epub 2020 Oct 14.

Abstract

Background: Cardiac emboli secondary to atrial fibrillation (AF) commonly cause large vessel occlusions (LVO) that require endovascular thrombectomy (EVT) to restore cerebral circulation. Whether the outcome of patients with AF diagnosed after the index stroke (newAF) differs from that of AF-patients in which AF was known before stroke (kAF) remains unknown.

Patients and methods: Consecutive LVO patients treated with EVT were recruited and the data was analyzed retrospectively. We compared patients with newAF to those with kAF and those without AF.

Results: Among 230 patients included, 109 (47%) had AF (86 kAF, 23 newAF). Patients with kAF more often had prior strokes compared with those with newAF (20% vs. 4% p = 0.04) but other parameters did not differ between the groups. Both AF groups were significantly older, more often reached favorable recanalization and less often had favorable outcomes compared to those without AF. On multivariate analyses, timing of AF detection did not influence survival (Odds Ration [OR] 0.89 95% Confidence Interval [CI] 0.28-1.90), chances for favorable recanalization (OR 1.2 95% CI 0.44-3.26) or favorable outcome 1.32 (95% CI 0.57-3.05).

Conclusions: Timing of AF diagnosis does not appear to influence outcome in patients with LVO that underwent EVT.

Keywords: Atrial fibrillation; Endovascular thrombectomy; Large vessel occlusion.

MeSH terms

  • Atrial Fibrillation* / complications
  • Atrial Fibrillation* / diagnosis
  • Atrial Fibrillation* / surgery
  • Endovascular Procedures*
  • Humans
  • Retrospective Studies
  • Stroke* / complications
  • Stroke* / surgery
  • Thrombectomy
  • Treatment Outcome