Is there a relationship between the index of electrophysiological balance and newly diagnosed atrial fibrillation in ischemic stroke patients?

Objective: The objective of this study was to investigate the association between the index of electrophysiological balance (iCEB) and ischaemic stroke (IS) and newly diagnosed atrial fibrillation (AF). AF is an independent risk factor for stroke. Study design: This is an observational study. Place and duration of the study: The study was conducted at the institution where the authors are employed (Şehit Prof Dr Ilhan Varank Training and Research Hospital, Istanbul, between 1 October 2021 and 1 April 2022).

Methodology: We included 452 patients in this study diagnosed with IS. The patients participating in the research were separated into two categories: patients with and without AF on rhythm holter. Both groups were balanced in point of clinical, demographic, and echocardiographic features. iCEB was described and evaluated as the proportion of QT to QRS (QT/QRS); and ciCEB (QTc/QRS). A p-value under 0.05 was noted as significant.

Results: The mean old of the participants in the AF group (n = 250) was 72.4 ± 9.5 years but the control group (n = 202) was 62.1 ± 12.6) years (p < 0.001). Both groups were similar in point of demographic and clinical features. CHA₂DS₂-VASc score (5.2 ± 1.5 vs 4.3 ± 1.3, p < 0.001), QT duration (412.3 ± 48.1 vs 404.5 ± 41.5 ms, p = 0.029), cQT duration (456.3 ± 35.4 vs 441.9 ± 33.2 ms, p = 0.017), iCEB (4.4 ± 0.7 vs 4.1 ± 0.6 ms, p = 0.007), ciCEB (4.9 ± 0.8 vs 4.6 ± 0.4 ms, p = 0.005) were higher in the AF group. Multivariable analyses confirmed that only age (OR:1.075, 95% CI [1.058-1.107], p < 0.001) and the iCEB (OR:1.781, 95% CI [1.128 - 2.812], p = 0.013) are potential independent risk factors for AF events with ischaemic stroke patients.

Conclusion: The study concluded with the finding that iCEB and ciCEB values were elevated in patients who presented with IS and AF events detected on rhythm Holter. Concurrently, these patients exhibited higher CHA₂DS₂-VASc scores and advanced age. Furthermore, the iCEB parameter was found to be a valuable predictor of AF in patients with ischaemic stroke and normal sinus rhythm.