Documentation of atrial fibrillation prior to first‐ever ischemic stroke

Objectives We assessed the prevalence of atrial fibrillation ( AF ) prior to first‐ever ischemic stroke by examining a comprehensive electronic ECG archive. Methods The study sample comprised 336 consecutive stroke patients (median age 76 ( IQ 16) y, 200 men) enrolled in L und S troke R egister from M arch 2001 to F ebruary 2002 and 336 age‐ and gender‐matched controls without stroke history. AF prior to admission was studied using the regional electronic ECG database and record linkage with the N ational S wedish H ospital D ischarge R egister ( SHDR ). Medical records were reviewed for AF documentation and CHA 2 DS 2 ‐ VAS c risk score. Results Atrial fibrillation before or at stroke onset was detected in 109 (32.4%) stroke patients and 44 (13.1%) controls, P  <   0.001. Twenty‐five of 109 stroke patients had AF detected only on previous ECG ( n  =   14) or through the SHDR ( n  =   11). The most prevalent type of AF in stroke group was non‐permanent AF (59.6%). AF prevalence among patients admitted with sinus rhythm at hospital admission ( n  =   266) was higher in those with CHA 2 DS 2 ‐ VAS c score ≥ 6 (28.6%) than with CHA 2 DS 2 ‐ VAS c score < 6 (13.0%), P  = 0.043. Conclusion Comprehensive approach for AF screening allows detecting AF in one‐third of patients admitted with first‐ever ischemic stroke. Patients with high cardiovascular risk are more likely to have non‐permanent AF .