Awareness of the Role of Atrial Fibrillation as a Cause of Ischemic Stroke

STROKEAHA: December 19, 2013

Atrial fibrillation (AF) in the presence of mitral stenosis, a consequence of rheumatic heart disease, was long recognized as the basis for cerebral infarction. Although it had long been acknowledged that atrial stasis resulting from mitral stenosis, often in the presence of AF, predisposed to thrombus formation, investigators questioned whether the AF played a role in the occurrence of systemic embolism, including stroke. As examples, in 1951, the esteemed Boston cardiologists Harris and Levine concluded, “…one wonders whether AF has much importance in influencing thrombus formation in mitral stenosis.”¹

In his memoirs, Fisher² recounts the events in 1949 soon after his arrival as a graduate fellow in neuropathology at the Boston City Hospital. Read more