Abstract
Background and Purpose
Atrial fibrillation (AF) is an established risk factor for stroke. Poststroke seizures (PSS) are a known complication after stroke. This review aimed to explore whether AF increases the likelihood of seizures after stroke and whether seizures might also be linked to the later development of AF.
Methods
We reviewed 11 observational studies involving patients with ischemic and hemorrhagic strokes, with substantial representation from Asian populations. Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated for both directions of association. Subgroup analyses were conducted based on stroke subtype, region, epilepsy-specific outcomes, sex, and age.
Results
AF was not significantly associated with the overall odds of PSS (OR = 1.00, P = .93). In ischemic stroke, AF showed a non-significant trend toward increased odds of PSS (OR = 1.28, P = .16), while no association was observed in hemorrhagic stroke (OR = 0.96, P = .80). A significant association was identified when focusing on poststroke epilepsy (OR = 2.09, P < .001). Studies from Asia demonstrated a stronger association (OR = 1.94, P < .001). Two studies examining PSS after AF found a significant association (OR = 2.87, P < .01). Female sex was slightly more common in patients with seizures (OR = 1.08, P = .02), particularly in ischemic stroke (OR = 1.11, P < .01). Patients with seizures were also marginally younger (Hedges’ g = −0.15, 95% CI: −0.20 to −0.11, P < .001).
Conclusions
AF may be associated with PSS, especially in epilepsy-focused and region-specific contexts. More studies are needed to understand the biological pathways behind these findings.
Get full access to this article
View all access options for this article.
References
Supplementary Material
Please find the following supplemental material available below.
For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.
For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.
