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Atrial fibrillation and silent stroke: links, risks, and challenges

Authors Hahne K, Mönnig G, Samol A

Received 16 September 2015

Accepted for publication 15 December 2015

Published 7 March 2016 Volume 2016:12 Pages 65—74

DOI https://doi.org/10.2147/VHRM.S81807

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Jaya Mallela

Peer reviewer comments 3

Editor who approved publication: Professor Daniel Duprez


Kathrin Hahne,1 Gerold Mönnig,2 Alexander Samol1

1Division of Cardiology, 2Division of Electrophysiology, Department of Cardiovascular Medicine, University Hospital Münster, Münster, Germany

Abstract: Atrial fibrillation (AF) is the most common cardiac arrhythmia, with a projected number of 1 million affected subjects in Germany. Changes in age structure of the Western population allow for the assumption that the number of concerned people is going to be doubled, maybe tripled, by the year 2050. Large epidemiological investigations showed that AF leads to a significant increase in mortality and morbidity. Approximately one-third of all strokes are caused by AF and, due to thromboembolic cause, these strokes are often more severe than those caused by other etiologies. Silent brain infarction is defined as the presence of cerebral infarction in the absence of corresponding clinical symptomatology. Progress in imaging technology simplifies diagnostic procedures of these lesions and leads to a large amount of diagnosed lesions, but there is still no final conclusion about frequency, risk factors, and clinical relevance of these infarctions. The prevalence of silent strokes in patients with AF is higher compared to patients without AF, and several studies reported high incidence rates of silent strokes after AF ablation procedures. While treatment strategies to prevent clinically apparent strokes in patients with AF are well investigated, the role of anticoagulatory treatment for prevention of silent infarctions is unclear. This paper summarizes developments in diagnosis of silent brain infarction and its context to AF.

Keywords: atrial fibrillation, silent strokes, cardiac embolic events, stroke risk

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