ArticleAnnals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc2017
Anticoagulation in patients at high risk of stroke without documented atrial fibrillation. Time for a paradigm shift?
Article in Annals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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Who cites it
15 citing papers in PubMed, 30 citations in OpenAlex.
- Electrocardiographic Indicators of Left Atrial Remodeling in Ischemic Stroke Patients with Atrial Fibrillation.Medical science monitor : international medical journal of experimental and clinical research · 2025Article
- Article
- Relationship between electrocardiographic interatrial blocks and echocardiographic indices of left atrial function in acute heart failure.Heart and vessels · 2022Article
- Premature atrial contractions: A predictor of atrial fibrillation and a relevant marker of atrial cardiomyopathy.Frontiers in physiology · 2022Review
- The Prevalence of Advanced Interatrial Block and Its Relationship to Left Atrial Function in Patients with Transthyretin Cardiac Amyloidosis.Journal of clinical medicine · 2021Article
- Beyond CHAEuropean heart journal supplements : journal of the European Society of Cardiology · 2020Article
- Interatrial block in prediction of all-cause mortality after first-ever ischemic stroke.BMC cardiovascular disorders · 2019Observational
- Usefulness of the Addition of Renal Function to the CHA2DS2-VASc Score as a Predictor of Thromboembolism and Mortality in Patients Without Atrial Fibrillation.The American journal of cardiology · 2018Article
- Reduced P-wave Voltage in Lead I is Associated with Development of Atrial Fibrillation in Patients with Coronary Artery Disease.Journal of atrial fibrillation · 2017Article
- Surface ECG interatrial block-guided treatment for stroke prevention: rationale for an attractive hypothesis.BMC cardiovascular disorders · 2017Article
- Atrial fibrillation in the elderly.Journal of geriatric cardiology : JGC · 2017Article
- Anticoagulation in elderly patients at high risk of atrial fibrillation without documented arrhythmias.Journal of geriatric cardiology : JGC · 2017Article
- Anticoagulation in patients at high risk of stroke without documented atrial fibrillation. Time for a paradigm shift?Annals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc · 2017Article
- Utility of P-Wave Dispersion in the Prediction of Atrial Fibrillation.Current health sciences journalArticle
- [Bayés Syndrome, Stroke and Dementia].Archivos peruanos de cardiologia y cirugia cardiovascularReview
Corrections and comments
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Authors and funding
4 authors at 3 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Atrial fibrillation (AF) is currently considered a risk factor for stroke. Depending on the severity of clinical factors (risk scores) a recommendation for full anticoagulation is made. Although AF is most certainly a risk factor for ischemic stroke, it is not necessarily the direct cause of it. The causality of association between AF and ischemic stroke is questioned by the reported lack of temporal relation between stroke events and AF paroxysms (or atrial high-rate episodes detected by devices). In different studies, only 2% of patients had subclinical AF > 6 minutes in duration at the time of stroke or systemic embolism. Is it time to consider AF only one more factor of endothelial disarray rather than the main contributor to stroke? In this "opinion paper" we propose to consider not only clinical variables predicting AF/stroke but also electrocardiographic markers of atrial fibrosis, as we postulate this as a strong indicator of risk of AF/stroke. We ask if it is time to change the paradigm and to consider, in some special situations, to protect patients (preventing stroke) who have no evidence of AF.
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Registered trials
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