Results were similar after excluding participants with a history of AF at baseline or new AF during follow-up. There was no definite association with noncardioembolic stroke subtypes (adjusted hazard ratio per SD, 1.14 95% confidence interval, 0.92-1.40). Which of the following is the most likely diagnosis (A) Anomalous return of pulmonary blood to the right atrium. P-wave terminal force in lead V1 was associated with ischemic stroke (adjusted hazard ratio per SD, 1.20 95% confidence interval, 1.03-1.39) and the composite of cryptogenic or cardioembolic stroke (adjusted hazard ratio per SD, 1.31 95% confidence interval, 1.08-1.58). X-rays of the chest show no abnormalities. RESULTS: Mean P-wave terminal force in lead V (☓368) μV*ms among stroke cases and 3934 (☒541) μV*ms in the subcohort. P mitrale is the wide and notched P wave of left atrial overload (left atrial abnormality), typically seen in lead II in mitral stenosis. Weighted Cox proportional hazard models were used to examine the association between P-wave terminal force in lead V1 and stroke etiologic subtypes while adjusting for baseline demographic characteristics, history of AF, heart failure, diabetes mellitus, hypertension, tobacco use, and lipid levels. P-wave terminal force in lead V1 was manually measured from baseline ECGs of participants in sinus rhythm who subsequently had ischemic stroke (n=241) and a randomly selected subcohort without stroke (n=798). METHODS: We conducted a case-cohort analysis in the Northern Manhattan Study, a prospective cohort study of stroke risk factors.
If true, we would expect an association with cryptogenic or cardioembolic stroke rather than noncardioembolic stroke. Symptoms and Diagnosis of Left Atrial Enlargement. Electrocardiographic Left Atrial Abnormality and Risk of Stroke: Northern Manhattan Study.īACKGROUND AND PURPOSE: Electrocardiographic left atrial abnormality has been associated with stroke independently of atrial fibrillation (AF), suggesting that atrial thromboembolism may occur in the absence of AF.
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