Differing peak durations of sporadic atrial fibrillation beyond 30 seconds after acute cardioembolic or non- cardioembolic stroke at aged patients

Purpose We aimed to explore the influence of aging on the duration of acute ischemic stroke (AIS)-related sporadic atrial fibrillation (AF) with a comparison of the cardioembolic stroke (CES) and noncardioembolic stroke (NCES) subsets. Methods Prospective 1062 continuous stroke patients were admitted between July 1, 2013, and December 31, 2020, and 877 were classified as having AIS. Of these, 433 patients (CES, n = 145; NCES, n = 288) met the Trial of Org 10172 in Acute Stroke Treatment (TOAST) criteria by magnetic resonance imaging and angiography. They underwent 24-h Holter monitoring and were divided according to AF duration (> 30 vs. 2.5–30 s) and stratified as prolonged but briefer AF (0.5–6 min) or prolonged AF (≥ 6 min). Results In the NCES group, patients with AF duration > 30 s were significantly older than those with AF duration of 2.5–30 s (p < 0.0008). Nearly all CES patients with AF > 30 s had prolonged AF (≥ 6 min), whereas AF duration of 0.5–6 min was significantly more frequent after NCES (odds ratio, 8.5; 95% confidence interval, 2.4–30.4). In participants ≥ 80 years with AF > 30 s, NCES patients had prolonged but briefer AF (0.5–6 min) significantly more often (p = 0.0069). Conclusions At AF > 30 s, durations ≥ 6 min were observed in almost all patients with acute CES. Prolonged but briefer AF (0.5–6 min) was observed in half of the NCES group. Patients aged ≥ 80 years with AF 0.5–6 min had NCES more often. Institutional Review Board of the Hokkaido Neurosurgical Memorial Hospital (registration number H25-2, 2013.7.1.)