title: Ischemic stroke phenotype in patients with nonsustained atrial fibrillation.
abstract: OBJECTIVE
  The widespread use of ambulatory cardiac monitoring has not only increased the detection of high-risk arrhythmias like persistent and paroxysmal atrial fibrillation (AF), but also made it possible to identify other aberrations such as short-lasting (<30 seconds) irregular runs of supraventricular tachycardia. Ischemic stroke phenotype might be helpful in understanding whether these nonsustained episodes play a similar role in stroke pathophysiology like their persistent and paroxysmal counterparts.
  
  
  METHODS
  In a consecutive series of patients with ischemic stroke, we retrospectively determined clinical and imaging features associated with nonsustained AF (n=126), defined as <30-second-lasting supraventricular tachyarrhythmias with irregular RR interval on 24-hour Holter monitoring, and compared them to patients with persistent/paroxysmal AF (n=239) and no AF (n=246).
  
  
  RESULTS
  Patients with persistent/paroxysmal AF significantly differed from patients with nonsustained AF by a higher prevalence of female sex (odds ratio [95% confidence interval], 1.8 [1.1-2.9]), coronary artery disease (1.9 [1.1-3.0]), and embolic imaging features (2.7 [1.1-6.5]), and lower frequency of smoking (0.4 [0.2-0.8]) and hyperlipidemia (0.5 [0.3-0.8]). In contrast, patients with no AF were younger (0.5 [0.4-0.6] per decade) and more likely to be male (1.7 [1.0-2.8]) in comparison with nonsustained AF population. The prevalence of nonsustained AF was similar among cryptogenic and noncryptogenic stroke patients (32% versus 29%). Voxel-wise comparison of lesion probability maps revealed no significant difference between cryptogenic stroke patients with and without nonsustained AF.
  
  
  CONCLUSIONS
  Clinical features of patients with nonsustained AF exhibited an intermediary phenotype in between patients with persistent/paroxysmal AF and no AF. Furthermore, imaging features did not entirely resemble patterns observed in patients with longer durations of AF.
authors: From the Department of Neurology, Faculty of Medicine (E.M.A., D.F.B., M.A.T.), Department of Cardiology, Faculty of Medicine (E.A.), and Department of Radiology, Faculty of Medicine (K.K.O.), Hacettepe University, Ankara, Turkey; and National Magnetic Resonance Research Center, Bilkent University, Ankara, Turkey (A.C.H.).
authors: Ethem M
authors: EM
authors: Arsava
authors: From the Department of Neurology, Faculty of Medicine (E.M.A., D.F.B., M.A.T.), Department of Cardiology, Faculty of Medicine (E.A.), and Department of Radiology, Faculty of Medicine (K.K.O.), Hacettepe University, Ankara, Turkey; and National Magnetic Resonance Research Center, Bilkent University, Ankara, Turkey (A.C.H.).
authors: Demet F
authors: DF
authors: Bas
authors: From the Department of Neurology, Faculty of Medicine (E.M.A., D.F.B., M.A.T.), Department of Cardiology, Faculty of Medicine (E.A.), and Department of Radiology, Faculty of Medicine (K.K.O.), Hacettepe University, Ankara, Turkey; and National Magnetic Resonance Research Center, Bilkent University, Ankara, Turkey (A.C.H.).
authors: Enver
authors: E
authors: Atalar
authors: From the Department of Neurology, Faculty of Medicine (E.M.A., D.F.B., M.A.T.), Department of Cardiology, Faculty of Medicine (E.A.), and Department of Radiology, Faculty of Medicine (K.K.O.), Hacettepe University, Ankara, Turkey; and National Magnetic Resonance Research Center, Bilkent University, Ankara, Turkey (A.C.H.).
authors: Arzu C
authors: AC
authors: Has
authors: From the Department of Neurology, Faculty of Medicine (E.M.A., D.F.B., M.A.T.), Department of Cardiology, Faculty of Medicine (E.A.), and Department of Radiology, Faculty of Medicine (K.K.O.), Hacettepe University, Ankara, Turkey; and National Magnetic Resonance Research Center, Bilkent University, Ankara, Turkey (A.C.H.).
authors: Kader K
authors: KK
authors: Oguz
authors: From the Department of Neurology, Faculty of Medicine (E.M.A., D.F.B., M.A.T.), Department of Cardiology, Faculty of Medicine (E.A.), and Department of Radiology, Faculty of Medicine (K.K.O.), Hacettepe University, Ankara, Turkey; and National Magnetic Resonance Research Center, Bilkent University, Ankara, Turkey (A.C.H.).
authors: Mehmet A
authors: MA
authors: Topcuoglu
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000503:physiopathology*; D002545:Brain Ischemia / Q000503:physiopathology; D015716:Electrocardiography, Ambulatory / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010641:Phenotype; D011336:Probability; D012189:Retrospective Studies; D020521:Stroke / Q000503:physiopathology*; D013617:Tachycardia, Supraventricular / Q000175:diagnosis
keywords: atrial fibrillation; electrocardiography, ambulatory; magnetic resonance imaging