Assessment Of Frequency And Outcomes Of Atrial Fibrillation In Patients Presenting With Ischemic Stroke

Objective: To determine the frequency of atrial fibrillation in patients presenting with ischemic stroke and outcome in terms of death or survival at the time of discharge from the tertiary care hospital in Quetta. Patients and methods: This case series study was carried out in a period of one year from May 2014 to April 2015 at Neurology department, Bolan Medical Complex Hospital, Quetta, Pakistan. A sample of 136 patients of age >20 years &<60 years who were ischemic stroke diagnosed on MRI were included. Patients with the transientischemic attack, subarachnoid hemorrhage, cerebral infections Meningitis (Bacterial, tuberculous, viral) and epileptic seizures were excluded. Frequencies and percentages were expressed for categorical variables like gender, outcome variables i-e; presence or absence of AF and survival. Effect modification tested through Chi-square with P value < 0.05 significant. Results: The mean ± SD age of patients was 49.13 ±7.13 years (Range: 35-60). Mean ± SD duration of disease (presenting symptoms of stroke) was 8.62 ± 6.48 hours (Range of 1-29). Male to female ratio was 6.62:1 and male patients were 87.76% (n= 118) while only 13.24% (n= 18) were females. The frequency of AF among patients of ischemic stroke was 21.32% (n= 29) and 3.68% (n= 5) did not survive. Stratified analysis showed that the age, gender, residence and duration of disease were effect modifiers for the frequency of atrial fibrillation as well as the outcome among ischemic stroke patients. Conclusion: Every one out of five ischemic stroke patients may have atrial fibrillation as comorbidity or the underlying reason. Elder age, especially female after menopause, late presenters and those referred from rural areas should be screened thoroughly for atrial fibrillation as a possible underlying diagnosis.