![]() Results from EMBRACE Trial and several studies also have revealed that excessive APBs is associated with the development of atrial fibrillation and adverse cardiovascular events 25, 26, 27. On the other hand, there have been several works on the association between the burden or frequency of atrial ectopic beats and recurrent stroke, transient ischemic attack, and death 21, 22, 23, 24. In addition to several studies dealing with the relationship between AF type and stroke risk, some studies on the relationship between implantable cardiac device-detected AF burden and thromboembolic risk, including stroke, have revealed that AF burden is associated with elevated risk for stroke and thromboembolism 18, 19, 20. Several studies have shown that patients with paroxysmal AF have a lower incidence rate of stroke than those with non-paroxysmal forms of AF, although they are less likely to receive oral anticoagulant (OAC) therapy in actual clinical practice 12, 16, 17. However, the association between the type of AF and stroke risk still remains controversial 15. Similarly, the Korean guidelines do not include the type of AF as a risk factor. Based on the results of previous studies, the current guidelines do not include the type of AF as a risk stratification factor 13, 14. ![]() To date, several studies have reported that patients with paroxysmal AF have a risk of stroke events similar to that in patients with persistent and permanent AF 9, 10, 11, 12. With the increasing epidemiological burden, AF is becoming an increasingly important factor in stroke occurrence 2, 3, 6, 7, 8. AF is also related to a five-fold increase in stroke risk, and one in five cases of stroke is attributed to AF 6, 7, 8. AF is associated with increased risk of mortality and many adverse outcomes such as stroke, thromboembolism, heart failure 5. These results suggest that the type of AF should be considered in stroke prevention and decision-making for oral anticoagulation in AF patients.Ītrial fibrillation (AF) is the most common cardiac arrhythmia, and it affects ~1–2% of the general population its prevalence is also increasing constantly with the increasing aging population 1, 2, 3, 4. The type of AF was associated with an increased risk of stroke, along with the difference of burden of ectopic beats (specially in APBs) in different types of AF. The risk of ischemic stroke was higher in non-paroxysmal AF with an adjusted hazard ratio (HR) of 2.08 (95% confidence interval, 1.33–3.25 p = 0.001) than in paroxysmal AF. The cumulative incidence of stroke events was significantly higher in non-paroxysmal AF than in paroxysmal AF (p < 0.001). During a median follow-up period of 16.8 months (Interquartile range, 11.67–20.52), a total of 82 (0.92%) patients experienced ischemic stroke with incidence rates of 0.50 and 1.09 events per 100 person-year for paroxysmal and non-paroxysmal AF, respectively. In terms of the difference in burden of ectopic beats, patients with non-paroxysmal AF had a higher proportion of atrial premature beats (APBs) (paroxysmal vs. The patients with a non-paroxysmal type of AF were older, male-predominant and had a higher prevalence of comorbidities and had more anticoagulation and rhythm control treatment than those with paroxysmal AF. We compared the burden of ectopic beats and stroke risk between patients with paroxysmal AF (n = 5,808) and non-paroxysmal AF (n = 3,075). In the prospective, multicenter observational registry with more than about 10,000 AF patients, 8883 non-valvular AF patients (mean age, 67.0 years 36% were women) with eligible follow-up visits participated. We investigated the difference of burden of atrial ectopic beats in different types of AF and the effect of the AF type on stroke risk in patients with non-valvular AF. The relationship between atrial fibrillation (AF) type and stroke risk is still controversial. ![]()
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