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Patients diagnosed with atrial fibrillation post-stroke generally have fewer associated health conditions, according to new research.
The study, published in The Lancet Neurology, found that atrial fibrillation (AF) has district characteristics when detected in patients who had a recent stroke compared to patients with known AF.
Dr. Luciano Sposato, lead author of the study, says this type of AF has a lower prevalence of risk factors, cardiovascular comorbidities, and changes associated with upper chambers of the heart.
These patients also have a 26% lower likelihood of experiencing another stroke than those with known AF.
In light of these new findings, the authors of the study are now proposing a new classification of heart rhythm and research standards to guide future research in the field, ensuring a more targeted and effective approach to secondary stroke prevention.
Decades of intense research
The study is based on various studies conducted by the authors over a decade of intense research in the field. This was compared to updated data from other groups.
The participants have undergone continuous heart monitoring, as typically the balance between the total duration of each ‘burst’ of atrial fibrillation and other risk factors is pivotal in understanding patient risk levels and designing better treatment options.
One of the main conclusions of the study was that patients diagnosed with AF post-stroke generally have fewer associated health conditions and a significantly lower likelihood of experiencing another stroke.
Not all stroke patients with AF will need anticoagulants
Current national and international guidelines recommend that all patients diagnosed with atrial fibrillation post-stroke are treated with anticoagulants, but some may not need this treatment, according to Dr. Sposato.
“To date, all patients diagnosed with atrial fibrillation after a stroke are treated with anticoagulants, except for when there is a clear contraindication.
“In the future, we may be able to identify patients with relatively lower risk who may not need to be treated with anticoagulants immediately but would need to be constantly monitored to detect changes in their risk profile,” he said.
However, Dr Sposato says more research is now needed to prove this concept, and AI-driven diagnostic tools are expected to take the lead in this area.
“Such tools may identify low-risk patients and may even flag moments in which their risk is transiently of permanently increased, requiring a change in their medications or prevention strategies,” he said.
A pilot clinical trial called STARGATE is currently underway to gather more evidence on the optimal duration and type of prolonged cardiac monitoring in stroke patients.