CORRELATION OF PAROXYSMAL SUPRAVENTRICULAR TACHYCARDIA, ATRIAL-FIBRILLATION, AND SINUS RHYTHM WITH INCIDENCES OF NEW THROMBOEMBOLIC STROKE IN 1476 OLD-OLD PATIENTS

The relationship between supraventricular tachycardia and the incidenc e of thromboembolic stroke has not been previously reported. We invest igated in a prospective study the incidence of new thromboembolic stro ke in 1476 patients, mean age 81 years, with atrial fibrillation, paro xysmal supraventricular tachycardia, or sinus rhythm detected by 24-ho ur ambulatory electrocardiograms. New thromboembolic stroke developed at 31-month follow-up in 87 of 201 patients (43%) with atrial fibrilla tion, at 43-month follow-up in 84 of 493 patients (17%) with paroxysma l supraventricular tachycardia, and at 45-month follow-up in 143 of 78 2 patients (18%) with sinus rhythm (p<0.0001 comparing atrial fibrilla tion with paroxysmal supraventricular tachycardia or sinus rhythm). Ka plan-Meier survival curves showed a higher significance of thromboembo lic stroke in patients with atrial fibrillation, compared to patients with paroxysmal supraventricular tachycardia or sinus rhythm (log-rank : p<0.0001). Multivariate Cox regression model showed that independent significant predictors of thromboembolic stroke were: a) atrial fibri llation (relative risk = 3.31); b) prior thromboembolic stroke (relati ve risk = 2.85); c) sex (relative risk for women = 0.75); and d) age ( relative risk = 1.02). These data show that atria] fibrillation is an independent predictor of thromboembolic stroke in elderly patients, an d that paroxysmal supraventricular tachycardia is not associated with thromboembolic stroke.