The predictive factors for cerebral infarction in patients with non-rheumatic atrial fibrillation

To investigate possible factors predicting cerebral infarction (CI) in patients with non-rheumatic atrial fibrillation, we reviewed the clinical records of 79 patients in whom conversion from sinus rhythm to persistent atrial fibrillation was confirmed by serial electrocardiographic tracings. The patients averaged 68.4 years in age and their average observation period after transition to persistent atrial fibrillation was 4.1 years. During the observation period, 20 patients developed CI. CI occurred in 10 of 22 patients with hypertensive heart disease, but in only three of 30 patients with lone atrial fibrillation and the difference was statistically significant (p less than 0.01). We compared demographic and pathophysiologic factors recorded at the onset of fixed atrial fibrillation between groups with and without CI. There were no significant differences in age, sex, smoking habits, diabetic complications and serum cholesterol level, but hematocrit level was significantly higher in patients with CI than in those without CI (45.3 +/- 3.2% vs 42.3 +/- 4.4%, p less than 0.01). The cardiothoracic ratio was not significantly different, but echocardiographic left atrial dimension was significantly greater in patients with CI than in those without CI (43.7 +/- 3.3 mm vs 38.6 +/- 5.8 mm, p less than 0.01). The left ventricular ejection fraction was significantly lower in patients with CI than in those without CI (62.2 +/- 16.6% vs 72.9 +/- 8.2%, p less than 0.05) and congestive heart failure was significantly more frequent in patients with CI than in those without CI (40.0% vs 13.6%, p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)