Non-ECG predictors of atrial fibrillation in ischaemic stroke: A systematic review

The use of novel biomarkers to predict future atrial fibrillation (AF) risk may aid decision making with anti-coagulant therapy for stroke prevention. The purpose of our study was to determine whether quantitative echocardiography, blood tests, imaging, anthropometry are predictive of atrial fibrillation. Electrocardiography was not the scope of this review.

Incremental increases in atrial volume and atrial diameter were most commonly associated with AF development. Likewise, incremental Brain Natriuretic Peptide (BNP) and N-terminal pro-(BNP) levels also correlate with AF risk. Anthropometric predictors such as BMI, lean mass and fat mass were also predictive of AF. Of studies reporting stroke topology, the presence of cortical infarcts, posterior circulation infarcts, multi-territory infarcts were independently predictive of AF.

Newer echocardiographic techniques such as atrial and ventricular strain analysis were shown to be predictive of AF in multiple studies. Use of these biomarkers in composite scoring systems may accurately predict AF development and further help stratify patients that may benefit from anticoagulation for stroke prevention.