![]() We used a Get-With-The-Guideline registry data to identify consecutive patients who presented with ischemic stroke during the most recent 8-month period between January and August, 2018 at a single tertiary academic medical center (University of Virginia Medical Center). We conducted a retrospective case-control study. Since the speculated mechanism of the association between abnormal PTFV1 and ischemic stroke is cardiac embolism resulting from pathological LA, among patients with ischemic stroke, we also examined whether PTFV1 in those presenting with either cardioembolic or cryptogenic stroke subtypes would be more abnormal compared to those with other subtypes. ![]() In this study, we tested the hypothesis that patients presenting with ischemic stroke would have more abnormal PTFV1 than a comparable group without ischemic stroke. Although speculated, whether patients presenting with ischemic stroke in a real-world clinical setting actually have more abnormal PWIs has not been examined. ( 4– 6) These ECG markers collectively called P wave indices (PWI), represent LA electrical remodeling, which may not accompany gross LA structural abnormalities.( 7) Among PWI, P wave terminal force in lead V1 (PTFV1) has been most consistently associated with ischemic stroke in prospective cohort studies.( 8) While the exact mechanism of this connection remains unclear, abnormal LA structural or electrophysiological remodeling may increase the risk for cardiac thrombus formation, leading to cardioembolic stroke. Structural change in the left atrium (LA) manifested as LA enlargement is associated with the risk of ischemic stroke.( 1– 3) Moreover, selective electrocardiographic (ECG) markers of LA pathology predict ischemic stroke independent of atrial fibrillation (AF), a well-established cause of cardioembolic stroke. ![]() A series of investigations have linked cardiac structural abnormality with ischemic stroke. As such, identification of individuals at risk is critical in light of possible preventive measures. Ischemic stroke is one of the leading causes of long-term disability and mortality globally. ![]()
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