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To examine the relationship between atrial fibrillation and mortality after stroke,we studied 186 men and 167 women from the Waikato Stroke Registry whose mean age was 75.2+/-7.5 years.Twenty-three percent(82 of 353)had atrial fibrillation or flutter on their admission electrocardiogram.This group differed significantly from that with sinus rhythm in three respects:1)They were older(p,0.01);2)they had more severe current stroke deficit as evidenced by lower limb power(p,0.05)and Mini- Mental State Score(p<0.001),higher incidence of homonomous hemianopia(p<0. 05),and lower incidence of lacunar syndrome stroke(p<0.001);and 3)they had a significantly higher incidence of cardiomegaly and congestive heart failure(p<0.01).Functional outcome was insignificantly better in the group with sinus rhythm.During a mean follow-up period of 18 months,mortality was significantly higher in the group with atrial fibrillation(p=0.001). Proportional hazards modeling,however,showed that the apparently poorer survival in those patients with atrial fibrillation could be explained by factors other than cardiac rhythm,such as age,Mini-Mental State Score, level of consciousness,and interstitial edema on admission chest radiography.Thus,atrial fibrillation was not an independent predictor of survival after stroke. |
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