Authors : Baishyak Renuji, Ashley Thomas Mathen
DOI : 10.18231/j.ijn.2025.005
Volume : 11
Issue : 1
Year : 2025
Page No : 23-27
Background: Stroke is a major cause of morbidity and mortality worldwide, with ischemic strokes accounting for approximately 85% of all strokes. Atrial fibrillation (AF), a common cardiac arrhythmia characterized by rapid and irregular electrical activity in the atria, leading to uncoordinated contraction of the atrial muscle, is considerably a crucial risk factor for ischemic stroke, as it increases the risk of stroke by five-fold. The study aimed to assess the prevalence of atrial fibrillation among ischemic stroke patients at a tertiary care hospital in Kerala, India. Materials and Methods: This retrospective cross-sectional study was conducted at a tertiary care hospital in South India from 2021 to 2022. A total of 264 ischemic stroke patients aged ?18 years were included, with exclusions for patients with possible functional weakness. Diagnostic tests, including 12-lead electrocardiography (ECG), Holter monitoring (24-72 hours), echocardiography, and imaging (MRA/CTA), were reviewed to detect AF and determine stroke aetiology based on the TOAST classification. Results: The overall prevalence of AF among ischemic stroke patients was 4.9%. With respect to TOAST classification, Cardioembolism was found in 2.7% of the subjects, Large artery atherosclerosis in 33%, Small artery disease in 11.4%, Other determined causes in 1.1%, and Undetermined cause in 51.9%. By excluding ‘Not completely evaluated’ cases, corrected proportion of each diagnosis in TOAST classification showed Cardioembolism to be 4.1%, Large artery atherosclerosis 51.5%, Small artery disease 17.7%, Other determined causes 1.8% and Undetermined causes to constitute 24.9%. Conclusion: The prevalence of atrial fibrillation in ischemic stroke patients was found to be lower in our study compared to other studies probably due to the fewer amount of Holter done in these cases. This was due to multiple reasons such as financial reasons and high case load, emphasizing the need for systematic AF screening using the same. Improved detection and early management of AF in stroke patients could enhance outcomes, underlining the importance of comprehensive diagnostic workups for stroke care in developing nations like India. Keywords: Toast, AF, Ischemic stroke, Cardioembolism