Hemodynamic blood flow disturbances in the middle cerebral arteries in patients with atrial fibrillation during acute ischemic stroke.

ABSTRACT

OBJECTIVES: The purpose of the present study was to evaluate whether blood flow in the middle cerebral arteries (MCAs) in patients with atrial fibrillation (AF) during acute ischemic stroke is disturbed, as well as to assess if potential disturbances result from arrhythmia rather than a consequence of an embolus within the cerebral circulation. PATIENTS AND METHODS: A total of 180 subjects were included in the study; 90 consecutive patients with AF and 90 consecutive patients in sinus rhythm who were admitted to the Stroke Unit of the Department of Neurology at Pomeranian Medical University Hospital in Szczecin, Poland within 24h of the onset of ischemic stroke symptoms. During the acute phase of the stroke (24h), all patients underwent transcranial Doppler ultrasonography (TCD) with assessment of mean blood flow velocity (MV) in the MCAs. RESULTS: We observed significantly lower values of MV in MCAs of both damaged and intact hemispheres in patients with AF as compared to patients in sinus rhythm. CONCLUSION: In patients with AF, hemodynamic disturbances occur within the cerebral circulation during acute ischemic stroke which can cause a more severe course and worse stroke outcome. AF patients need more appropriate prevention of stroke, as well as more efficient treatment during acute ischemic stroke.