MRI indicated silent cerebral ischemia lesions in 89% patients with paroxysmal Afib and 92% with persistent Afib compared with 46% of controls, which wasn’t significantly different between the two types of Afib but was for both versus controls (P<0.01).
The number of these lesions averaged 41 in persistent Afib, 33 in paroxysmal Afib, and 12 in controls, which was significantly different for all three groups.
The high prevalence of these lesions in the control group compared with what has been reported in the general population may have reflected the moderate to high cardiovascular risk among these patients referred for cardiovascular prevention or treatment, the researchers suggested.
The lesions can have either ischemic and embolic origins, but the peculiar “spotted” distribution of “small sharply demarcated lesions, often in cluster, with bilateral distribution, prevalently in the frontal lobe” seen in 50% and 67% of the paroxysmal and persistent Afib patients, respectively, strongly supported an embolic mechanism, they noted.
If these findings are replicated in future studies, the question for underwriters is should any Afib risk be Standard mortality?