{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T11:41:21Z","timestamp":1760960481708,"version":"build-2065373602"},"reference-count":55,"publisher":"MDPI AG","issue":"20","license":[{"start":{"date-parts":[[2025,10,19]],"date-time":"2025-10-19T00:00:00Z","timestamp":1760832000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Victor Babe\u0219 University of Medicine and Pharmacy, Timisoara"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background: The ongoing discourse surrounding the connection between atrial fibrillation (AF) and stroke continues to be a topic of considerable discussion. Atrial fibrillation (AF) is a well-established risk factor for ischemic stroke, yet the prognostic significance of paroxysmal AF in functional recovery remains uncertain. While persistent AF has consistently been associated with more severe strokes and poorer outcomes, evidence regarding paroxysmal AF is limited and conflicting. This research examines how paroxysmal AF influences the severity of post-stroke disability in individuals experiencing acute ischemic stroke. Materials and Methods: A total of 236 patients presenting with acute ischemic stroke and cardiovascular risk factors were evaluated upon admission to the Neurology Department. Of these, 118 patients with paroxysmal AF were assigned to Group A, and 118 patients without AF were assigned to Group B. To determine the severity of disability, clinical, neurological, and imaging assessments were performed utilizing the modified Rankin Scale (mRS), Activities of Daily Living (ADL) score, National Institutes of Health Stroke Scale (NIHSS), and Medical Research Council (MRC) scale. Results: Patients in Group A exhibited significantly poorer outcomes in comparison to those in Group B, evidenced by lower ADL scores, elevated NIHSS and MRC scores, and increased levels of disability (p &lt; 0.05). Within Group A, a stronger correlation was observed between mRS scores and neurological symptoms, motor deficits, and daily functioning. Logistic regression analysis indicated that among all stroke patients (comprising Groups A and B), the probability of experiencing moderate to severe disability (mRS \u2265 3) escalated by 31.6% for each unit increase in NIHSS and diminished by 64.5% for every unit increase in MRC. In Group A, an increase of one unit in ADL correspondingly lowered the risk of mRS \u2265 3 by 22.7%, in contrast to a reduction of 17.8% in the overall stroke population (Groups A and B combined). Additionally, an enhancement in MRC score led to an 83.5% decrease in the risk of disability within Group A, compared to a 75.8% reduction in Group B. Moreover, in Group A, each unit increment in the HAS-BLED score was associated with a 32.5% rise in the risk of severe disability (OR = 1.325; 95% CI: 1.015\u20131.729; p &lt; 0.05). Conclusions: Paroxysmal atrial fibrillation was significantly associated with a higher risk of moderate to severe disability following acute ischemic stroke compared to patients without AF. The severity of post-stroke disability in Group A is closely linked to reduced functional independence (lower ADL), more pronounced neurological impairment (higher NIHSS), greater motor deficits (lower MRC), and increased bleeding risk (higher HAS-BLED score). These findings highlight the importance of early identification and comprehensive monitoring of functional, neurological, and cardiovascular parameters in stroke patients with paroxysmal AF. Tailored rehabilitation strategies aimed at improving motor function, daily living activities, and controlling hemorrhagic risk can play a crucial role in reducing long-term disability and enhancing the reintegration of these patients into family and social life.<\/jats:p>","DOI":"10.3390\/diagnostics15202637","type":"journal-article","created":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T09:23:34Z","timestamp":1760952214000},"page":"2637","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Prognostic Impact of Paroxysmal Atrial Fibrillation on Disability Severity and Activity of Daily Living After Acute Ischemic Stroke"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3464-5782","authenticated-orcid":false,"given":"Marius","family":"Militaru","sequence":"first","affiliation":[{"name":"Department of Neuroscience, Neurology II University Clinic, \u201cVictor Babes\u201d University of Medicine and Pharmacy, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania"},{"name":"Emergency City Clinical Hospital Timisoara, Gheorghe Dima Street Nr. 5, 300254 Timisoara, Romania"},{"name":"Centre of Advanced Research in Cardiology and Hemostasology, \u201cVictor Babes\u201d University of Medicine and Pharmacy, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel-Florin","family":"Lighezan","sequence":"additional","affiliation":[{"name":"Emergency City Clinical Hospital Timisoara, Gheorghe Dima Street Nr. 5, 300254 Timisoara, Romania"},{"name":"Centre of Advanced Research in Cardiology and Hemostasology, \u201cVictor Babes\u201d University of Medicine and Pharmacy, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania"},{"name":"Department of Internal Medicine I, Medical Semiology I University Clinic, \u201cVictor Babes\u201d University of Medicine and Pharmacy, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9814-9561","authenticated-orcid":false,"given":"Florina","family":"Buleu","sequence":"additional","affiliation":[{"name":"Department of Cardiology, \u201cVictor Babes\u201d University of Medicine and Pharmacy, E. Murgu Square No. 2, 300041 Timisoara, Romania"},{"name":"Emergency County Hospital \u201cPius Brinzeu\u201d, 325100 Timisoara, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stela","family":"Iurciuc","sequence":"additional","affiliation":[{"name":"Emergency City Clinical Hospital Timisoara, Gheorghe Dima Street Nr. 5, 300254 Timisoara, Romania"},{"name":"Department of Cardiology, \u201cVictor Babes\u201d University of Medicine and Pharmacy, E. Murgu Square No. 2, 300041 Timisoara, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-1728-3552","authenticated-orcid":false,"given":"Daian Ionel","family":"Popa","sequence":"additional","affiliation":[{"name":"Emergency City Clinical Hospital Timisoara, Gheorghe Dima Street Nr. 5, 300254 Timisoara, Romania"},{"name":"Doctoral School, Faculty of General Medicine, \u201cVictor Babes\u201d University of Medicine and Pharmacy, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania"},{"name":"Research Center for Medical Communication, \u201cVictor Babes\u201d University of Medicine and Pharmacy, 300041 Timisoara, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7362-3714","authenticated-orcid":false,"given":"Adriana","family":"Cojocaru","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, Discipline of Pedopsychiatry \u201cVictor Babes\u201d University of Medicine and Pharmacy, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania"},{"name":"Clinical Department of Child and Adolescent Psychiatry, Children\u2019s Emergency Hospital \u201cLouis Turcanu\u201d, \u201cVictor Babes\u201d University of Medicine and Pharmacy, 2 Eftimie Murgu Square, 300041 Timisoara, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tiberiu","family":"Buleu","sequence":"additional","affiliation":[{"name":"Emergency County Hospital \u201cPius Brinzeu\u201d, 325100 Timisoara, Romania"},{"name":"Faculty of Nursing, \u201cVictor Babes\u201d University of Medicine and Pharmacy, 300041 Timisoara, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5455-5341","authenticated-orcid":false,"given":"Anda Gabriela","family":"Militaru","sequence":"additional","affiliation":[{"name":"Emergency City Clinical Hospital Timisoara, Gheorghe Dima Street Nr. 5, 300254 Timisoara, Romania"},{"name":"Centre of Advanced Research in Cardiology and Hemostasology, \u201cVictor Babes\u201d University of Medicine and Pharmacy, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania"},{"name":"Department of Internal Medicine I, Medical Semiology I University Clinic, \u201cVictor Babes\u201d University of Medicine and Pharmacy, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,10,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1016\/S0140-6736(13)61953-4","article-title":"Global and regional burden of stroke during 1990\u20132010: Findings from the Global Burden of Disease Study 2010","volume":"383","author":"Feigin","year":"2014","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"417","DOI":"10.1016\/S1474-4422(19)30030-4","article-title":"The global burden of stroke: Persistent and disabling","volume":"18","author":"Gorelick","year":"2019","journal-title":"Lancet Neurol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"126","DOI":"10.1111\/ijs.12206","article-title":"A multicenter, randomized, controlled study to investigate EXtending the time for Thrombolysis in Emergency Neurological Deficits with Intra-Arterial therapy (EXTEND-IA)","volume":"9","author":"Campbell","year":"2014","journal-title":"Int. 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