Traditionally, it was generally held that atrial fibrillation (AF) is a major cause of ischemic cerebrovascular accident (ICVA) due to the blood flow stasis and thrombus formation in a poorly contractile atrium and left atrial appendage during AF episodes. Nevertheless, studies described a lack of a clear temporal association between AF episodes and ICVA (
). Moreover, there is comparable incidence of ICVA between rate- and rhythm-control strategies in AF. Therefore, in the absence of AF, an abnormal atrial substrate may be the cause of embolism independent of AF (
- Brambatti M.
- Connolly S.J.
- Gold M.R.
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Temporal relationship between subclinical atrial fibrillation and embolic events.
Circulation. 2014; 129: 2094-2099https://doi.org/10.1161/CIRCULATIONAHA.113.007825
). This fact may imply that AF is more likely a marker of ICVA in later stages of abnormal atrial substrate. Hence, we should concentrate in finding ways of diagnosing earlier stages of abnormal atrial substrate, instead of waiting for AF to appear.
- Kamel H.
- Okin P.M.
- Elkind M.S.V.
- Iadecola C.
Atrial fibrillation and mechanisms of stroke: time for a new model.
Stroke. 2016; 47: 895-900https://doi.org/10.1161/STROKEAHA.115.012004
Abbreviations:ECG left atrial abnormality. (Atrial Fibrillation)
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- Temporal relationship between subclinical atrial fibrillation and embolic events.Circulation. 2014; 129: 2094-2099https://doi.org/10.1161/CIRCULATIONAHA.113.007825
- Atrial fibrillation and mechanisms of stroke: time for a new model.Stroke. 2016; 47: 895-900https://doi.org/10.1161/STROKEAHA.115.012004
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Published online: May 26, 2023
Accepted: May 22, 2023
Received: May 18, 2023
Publication stageIn Press Journal Pre-Proof
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