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Not only chronic atrial fibrillation but also paroxysmal atrial fibrillation (PAF) is known to be a risk factor of cardioembolic stroke (CES). The value of transesophageal echocardiography (TEE) in addition to established clinical risk factors for stroke is controversial in patients with PAF. Altered hemostasis favoring thrombosis may contribute to formation of left atrial appendage (LAA) thrombus, but these conditions remain ill defined particularly in PAF (1). Left atrial mechanical remodeling has been established to play an important role in thrombogenesis as a potential cardiac source of embolism in patients with PAF (2), while it has not been clarified whether or not LAA dysfunction contributes to the occurrence of CES because of lack of data on the comparison of LAA function after cessation of PAF between patients with and without CES. Kaneko et al (3) compared parameters for LAA dysfunction on TEE between 17 patients with and 16 without CES after cessation of PAF.

A Sensitive Marker for Left Atrial Dysfunction as a Risk Factor of Cardioembolic Stroke after Cessation of Paroxysmal Atrial Fibrillation