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Am Fam Physician. 2000;62(1):196

The increased risk for stroke in patients with sustained atrial fibrillation has been well documented. By treating these patients with the appropriate anticoagulant therapy, physicians can reduce their risk. Relatively little is known about the risk of stroke in patients with intermittent atrial fibrillation. Hart and associates studied the risk of stroke in elderly patients who have intermittent atrial fibrillation.

A longitudinal cohort study was performed on 460 patients who were diagnosed with intermittent atrial fibrillation. Patients enrolled in the study could not have a reversible cause of atrial fibrillation or underlying cardiac disease. Independent risk factors for stroke were also analyzed. All patients received aspirin therapy during the study. A group of patients with sustained atrial fibrillation was used for comparison.

Patients with intermittent atrial fibrillation were more likely to be younger and women, and less likely to have heart failure than patients with sustained atrial fibrillation. The annualized rate of ischemic stroke in the intermittent atrial fibrillation group was no different than the rate in the sustained atrial fibrillation group.

The authors conclude that patients with intermittent atrial fibrillation were just as likely to have an ischemic stroke as those with sustained atrial fibrillation. Many elderly patients with intermittent atrial fibrillation would likely benefit from anticoagulation therapy.

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