{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T21:03:07Z","timestamp":1791925387804,"version":"4.3.4"},"reference-count":32,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[2000,2]]},"abstract":"<jats:p>\n            <jats:italic>Background and Purpose<\/jats:italic>\n            \u2014Atrial septal abnormalities have been associated with cryptogenic ischemic stroke in young patients, but the causal link has not yet been established. Paradoxical embolism is considered the most likely mechanism but is rarely proven. It can be hypothesized that, in those patients, paroxysmal atrial arrhythmias, potentially favored by the anatomic abnormalities, can be another cause of thrombus formation and subsequent embolism to the brain. In this study we assessed the relationship between atrial vulnerability, reflecting arrhythmogenic properties of the atria, and atrial septal abnormalities in young patients with cryptogenic ischemic stroke.\n          <\/jats:p>\n          <jats:p>\n            <jats:italic>Methods<\/jats:italic>\n            \u2014We enrolled 62 consecutive patients aged &lt;55 years who had ischemic stroke of unknown cause and transesophageal echocardiography to assess atrial septal aneurysm (ASA) or patent foramen ovale (PFO) (ie, atrial septal abnormalities). These patients underwent electrophysiological study to measure atrial refractoriness and conduction time defining a vulnerability index (ie, latent atrial vulnerability) and to assess the inducibility of sustained (lasting &gt;60 seconds) atrial fibrillation with the use of programmed atrial stimulation. Actual atrial vulnerability was defined by the presence of both latent vulnerability and inducibility of sustained atrial fibrillation lasting &gt;60 seconds.\n          <\/jats:p>\n          <jats:p>\n            <jats:italic>Results<\/jats:italic>\n            \u2014We found atrial vulnerability in 58% of patients with atrial septal abnormalities and in 25% of patients without (odds ratio=4.1 [95% CI, 1.3 to 12.7;\n            <jats:italic>P<\/jats:italic>\n            &lt;0.02]). The difference between patients with and without PFO or between patients with both PFO and ASA and those without were also significant. Patients with inducible sustained atrial fibrillation had more frequent past history of palpitations and syncope than patients without (\n            <jats:italic>P<\/jats:italic>\n            &lt;0.02).\n          <\/jats:p>\n          <jats:p>\n            <jats:italic>Conclusions<\/jats:italic>\n            \u2014Atrial vulnerability is associated with atrial septal abnormalities in patients with cryptogenic stroke. This result raises the question of the potential role of transient atrial arrhythmias in thrombus formation in the presence of PFO or ASA.\n          <\/jats:p>","DOI":"10.1161\/01.str.31.2.398","type":"journal-article","created":{"date-parts":[[2011,6,17]],"date-time":"2011-06-17T20:08:03Z","timestamp":1308341283000},"page":"398-403","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":197,"title":["Significant Association of Atrial Vulnerability With Atrial Septal Abnormalities in Young Patients With Ischemic Stroke of Unknown Cause"],"prefix":"10.1161","volume":"31","author":[{"given":"Karine","family":"Berthet","sequence":"first","affiliation":[{"name":"From the Departments of Neurology (K.B., M-G.B., P.A.) and Cardiology (A.C.), Saint-Antoine Hospital; Formation de Recherche en Neurologie Vasculaire (Association Claude Bernard) (M-G.B., P.A.); and Department of Cardiology, Broussais Hospital, Pierre and Marie Curie University (T.L., L.G., J-Y. Le H.), Paris, France."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Lavergne","sequence":"additional","affiliation":[{"name":"From the Departments of Neurology (K.B., M-G.B., P.A.) and Cardiology (A.C.), Saint-Antoine Hospital; Formation de Recherche en Neurologie Vasculaire (Association Claude Bernard) (M-G.B., P.A.); and Department of Cardiology, Broussais Hospital, Pierre and Marie Curie University (T.L., L.G., J-Y. Le H.), Paris, France."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ariel","family":"Cohen","sequence":"additional","affiliation":[{"name":"From the Departments of Neurology (K.B., M-G.B., P.A.) and Cardiology (A.C.), Saint-Antoine Hospital; Formation de Recherche en Neurologie Vasculaire (Association Claude Bernard) (M-G.B., P.A.); and Department of Cardiology, Broussais Hospital, Pierre and Marie Curie University (T.L., L.G., J-Y. Le H.), Paris, France."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Louis","family":"Guize","sequence":"additional","affiliation":[{"name":"From the Departments of Neurology (K.B., M-G.B., P.A.) and Cardiology (A.C.), Saint-Antoine Hospital; Formation de Recherche en Neurologie Vasculaire (Association Claude Bernard) (M-G.B., P.A.); and Department of Cardiology, Broussais Hospital, Pierre and Marie Curie University (T.L., L.G., J-Y. Le H.), Paris, France."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie-Germaine","family":"Bousser","sequence":"additional","affiliation":[{"name":"From the Departments of Neurology (K.B., M-G.B., P.A.) and Cardiology (A.C.), Saint-Antoine Hospital; Formation de Recherche en Neurologie Vasculaire (Association Claude Bernard) (M-G.B., P.A.); and Department of Cardiology, Broussais Hospital, Pierre and Marie Curie University (T.L., L.G., J-Y. Le H.), Paris, France."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Yves","family":"Le Heuzey","sequence":"additional","affiliation":[{"name":"From the Departments of Neurology (K.B., M-G.B., P.A.) and Cardiology (A.C.), Saint-Antoine Hospital; Formation de Recherche en Neurologie Vasculaire (Association Claude Bernard) (M-G.B., P.A.); and Department of Cardiology, Broussais Hospital, Pierre and Marie Curie University (T.L., L.G., J-Y. Le H.), Paris, France."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierre","family":"Amarenco","sequence":"additional","affiliation":[{"name":"From the Departments of Neurology (K.B., M-G.B., P.A.) and Cardiology (A.C.), Saint-Antoine Hospital; Formation de Recherche en Neurologie Vasculaire (Association Claude Bernard) (M-G.B., P.A.); and Department of Cardiology, Broussais Hospital, Pierre and Marie Curie University (T.L., L.G., J-Y. Le H.), Paris, France."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_1_2","doi-asserted-by":"publisher","DOI":"10.1161\/str.22.6.2057970"},{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/str.22.6.2057971"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/str.24.7.8322376"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/0735-1097(91)90539-L"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0404.1994.tb05225.x"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1161\/str.19.5.3363600"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1161\/str.25.1.8266377"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198805053181802"},{"key":"e_1_3_2_9_2","first-page":"11","volume":"2","year":"1998","unstructured":"Webster MWI, Chancelor AM, Smith HJ, Swift DL, Sharp DN, Bass NM. Patent foramen ovale in young stroke patients. Lancet. 1998;2:11\u201312.","journal-title":"Lancet"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1161\/str.24.12.8248969"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-117-6-461"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.eurheartj.a060524"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1161\/str.24.1.8418547"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-119-6-199309150-00003"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(85)80228-X"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1161\/circ.91.11.2785"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/0167-5273(95)02444-2"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(84)90101-2"},{"key":"e_1_3_2_19_2","unstructured":"Allessie MA Rensma PL Brugada J Smeets JLRM Penn O Kirchhof CJHJ. Pathophysiology of atrial fibrillation. In: Zipes DP Jalife J eds. Cardiac Electrophysiology: From Cell to Bedside. Philadelphia Pa: WB Saunders Co; 1990:548."},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/0167-5273(82)90032-8"},{"key":"e_1_3_2_21_2","first-page":"333","volume":"5","year":"1982","unstructured":"Michelucci A, Padeletti L, Fradella GA. Atrial refractoriness and spontaneous or induced atrial fibrillation. Acta Cardiol. 1982;5:333\u2013344.","journal-title":"Acta Cardiol"},{"key":"e_1_3_2_22_2","unstructured":"Attuel P Pellerin D Gaston J Seing S Quatre JM Mugica J Coumel P. Latent atrial vulnerability: new means of electrophysiologic investigations in paroxysmal atrial arrhythmias. In: Attuel P Coumel P Janse MJ eds. The Atrium in Health and Disease. Mount Kisco NY: Futura Publishing; 1989:159\u2013200."},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8159.1986.tb06680.x"},{"key":"e_1_3_2_24_2","first-page":"949","volume":"84","year":"1991","unstructured":"Quatre JM, Henry P, Bequet D, Bussiere JL, Ollivier JP, Attuel P. Etude \u00e9lectrophysiologique auriculaire des accidents vasculaires c\u00e9r\u00e9braux inexpliqu\u00e9s. Arch Mal Coeur Vaiss. 1991;84:949\u2013956.","journal-title":"Arch Mal Coeur Vaiss"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-8703(64)90371-0"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.89.4.1665"},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5223(19)36723-6"},{"key":"e_1_3_2_28_2","first-page":"1855","volume":"88","year":"1995","unstructured":"Reeb T, de Chillou C, Sadoul N, Lacour JC, Ducrocq X, Debouverie M, Weber M, Aliot E. Exploration \u00e9lectrophysiologique auriculaire des accidents vasculaires isch\u00e9miques c\u00e9r\u00e9braux inexpliqu\u00e9s. Arch Mal Coeur Vaiss. 1995;88:1855\u20131861.","journal-title":"Arch Mal Coeur Vaiss"},{"key":"e_1_3_2_29_2","first-page":"1365","volume":"89","year":"1996","unstructured":"Somody E, Albucher JF, Delay M, Chollet F, Bonnet J-P, Fourcade J, Guiraud-Chaumeil B, Puel J. Int\u00e9r\u00eat de l\u00ed\u00e9tude de la vuln\u00e9rabilit\u00e9 auriculaire latente dans l\u00edaccident vasculaire c\u00e9r\u00e9bral isch\u00e9mique inexpliqu\u00e9 du sujet jeune. Arch Mal Coeur Vaiss. 1996;89:1365\u20131373.","journal-title":"Arch Mal Coeur Vaiss"},{"key":"e_1_3_2_30_2","doi-asserted-by":"publisher","DOI":"10.1161\/circ.96.5.1686"},{"key":"e_1_3_2_31_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0008-6363(96)00077-6"},{"key":"e_1_3_2_32_2","doi-asserted-by":"publisher","DOI":"10.1016\/0735-1097(88)92614-9"}],"container-title":["Stroke"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/01.STR.31.2.398","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,12]],"date-time":"2024-05-12T22:07:21Z","timestamp":1715551641000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/01.STR.31.2.398"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2000,2]]},"references-count":32,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2000,2]]}},"alternative-id":["10.1161\/01.STR.31.2.398"],"URL":"https:\/\/doi.org\/10.1161\/01.str.31.2.398","relation":{},"ISSN":["0039-2499","1524-4628"],"issn-type":[{"value":"0039-2499","type":"print"},{"value":"1524-4628","type":"electronic"}],"subject":[],"published":{"date-parts":[[2000,2]]},"assertion":[{"value":"1999-08-02","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"1999-11-09","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2000-02-01","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}