Stratifying Stroke Risk in Atrial Fibrillation: Beyond Clinical Risk Scores

Shadi Yaghi, MD; Hooman Kamel, MD


Stroke. 2017;48(10):2665-2670. 

In This Article

Prediction of Stroke Risk Based on Electrocardiographic Markers

P-wave terminal force in lead V1 on a 12-lead ECG (ECG) can be used as a gauge of underlying LA abnormalities.[68] P-wave terminal force in lead V1 can be calculated by multiplying the duration and amplitude of the P wave in lead V1.[69] P-wave terminal force in lead V1 has been found to be associated with ischemic stroke risk in patients both with and without AF, suggesting that it provides additive information about stroke risk.[70] However, it has not been formally tested whether the addition of P-wave terminal force in lead V1 to commonly used clinical scores provides additional predictive ability. Furthermore, advanced interatrial block and Bayes syndrome are arrhythmogenic syndromes associated with atypical atrial flutter and AF and also predict nonlacunar cerebral ischemia and, probably, vascular dementia.[71]