ArticleEuropean heart journal supplements : journal of the European Society of Cardiology2020
Atrial fibrillation: villain or bystander in vascular brain injury.
Article in European heart journal supplements : journal of the European Society of Cardiology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
14 citing papers in PubMed, 1 synthesis or guideline pooled it, 31 citations in OpenAlex.
- 'Pill-in-the-pocket' Oral Anticoagulation Guided by Daily Rhythm Monitoring for Stroke Prevention in Patients with AF: A Systematic Review and Meta-analysis.Arrhythmia & electrophysiology review · 2023Pooled it
- Atrial fibrillation and acute coronary syndrome.EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology · 2024Article
- Perioperative stroke.Nature reviews. Disease primers · 2024Review
- Artificial Intelligence-enhanced Electrocardiogram for Atrial Fibrillation in Embolic Stroke With Undetermined Source: Heroic Detective or Overfitting Alarm?Korean circulation journal · 2023Article
- Incidence of Atrial Fibrillation in Large Vessel Occlusion and Large Embolic Stroke of Undetermined Source.Cureus · 2023Article
- [Atrial fibrillation and cognitive impairment: a narrative review].Revista de neurologia · 2022Review
- Left Atrial Volumes and Function, and Long-Term Incidence of Ischemic Stroke in the General Population.Journal of the American Heart Association · 2022Article
- Proteins and pathways in atrial fibrillation and atrial cardiomyopathy underlying cryptogenic stroke.International journal of cardiology. Heart & vasculature · 2022Article
- Article
- Atrial cardiopathy and cognitive impairment.Frontiers in aging neuroscience · 2022Review
- Impact of Catheter Ablation on Stroke, Cognitive Decline and Dementia.Arrhythmia & electrophysiology review · 2021Review
- Searching for atrial fibrillation post-stroke with prolonged monitoring: Do it early, but should we be looking for something else?International journal of cardiology. Heart & vasculature · 2021Article
- Interdisciplinary stroke care in 2020: the need for cardiologists to learn about stroke.European heart journal supplements : journal of the European Society of Cardiology · 2020Article
- Intra-cardiac thrombus detection by electrocardiogram-gated cardiac computed tomography in hyperacute ischemic stroke.Frontiers in neurologyArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 4 institutions in 4 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Atrial fibrillation (AF) and stroke are inextricably connected, with classical Virchow pathophysiology explaining thromboembolism through blood stasis in the fibrillating left atrium. This conceptualization has been reinforced by the remarkable efficacy of oral anticoagulant (OAC) for stroke prevention in AF. A number of observations showing that the presence of AF is neither necessary nor sufficient for stroke, cast doubt on the causal role of AF as a villain in vascular brain injury (VBI). The requirement for additional risk factors before AF increases stroke risk; temporal disconnect of AF from a stroke in patients with no AF for months before stroke during continuous ECG monitoring but manifesting AF only after stroke; and increasing recognition of the role of atrial cardiomyopathy and atrial substrate in AF-related stroke, and also stroke without AF, have led to rethinking the pathogenetic model of cardioembolic stroke. This is quite separate from recognition that in AF, shared cardiovascular risk factors can lead both to non-embolic stroke, or emboli from the aorta and carotid arteries. Meanwhile, VBI is now expanded to include dementia and cognitive decline: research is required to see if reduced by OAC. A changed conceptual model with less focus on the arrhythmia, and more on atrial substrate/cardiomyopathy causing VBI both in the presence or absence of AF, is required to allow us to better prevent AF-related VBI. It could direct focus towards prevention of the atrial cardiomyopathy though much work is required to better define this entity before the balance between AF as villain or bystander can be determined.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.