Abstract 14192: Stroke Recurrence and Atrial Fibrillation Occurrence in the Patients With Right Insular Stroke
Introduction: The right insular cortical lesion is believed to have the arrhythmogenic potential such as secondary atrial fibrillation(AF). The P wave-triggered signal-averaged electrocardiogram(SA-ECG) can detect the P wave dispersion which is related to the risk of AF. The stroke risk of secondary AF after right insular stroke remained unclear.
Hypothesis: We investigated the arrhythmogenic potential of right insular stroke, using SA-ECG and the stroke recurrence rate related to stroke location.
Methods: We recruited acute stroke patients who admitted from February 2012 to October 2013 and took routine work-up, including SA-ECG. Patients who had the previous history of AF before admission, were excluded. We checked the stroke recurrence and AF occurrence over two years after index stroke. We analyzed the difference of SA-ECG, AF occurrence and stroke recurrence rate between the right insular cortex lesion and other stroke.
Results: A total of 252 subjects were enrolled and 49 among them had right insular involvement. The patients with right insular lesion had longer P wave duration than the other stroke patients (154.0+29.6 vs. 133.5+26.5 ms, p<0.001). During observation period, stroke recurred in 28 patients and AF occurred in 50 persons. The patients with right insular lesion suffered from the AF occurrence and the stroke recurrence more frequently than those with other stroke lesions(AF occurrence, 33% vs 17%, P=0.01; Stroke Recurrence 25% vs 6%, P<0.01). Among the patients with AF occurrence, the patients with right insular lesion had the tendency of the higher stroke recurrence rate than those with the other stroke lesion(43.8% vs 20.6%, P=0.089).
Conclusions: Our result suggests that the right insular lesion is related to increased P wave dispersion and this might explain the development of secondary AF after right insular cortex stroke. Secondary AF after right insular lesion might have the higher stroke risk than that after other stroke lesion.
Author Disclosures: H. Park: None. S. Ko: None. J. Rha: None.
- © 2015 by American Heart Association, Inc.