We thank Drs. Sposato, Fridman, and Saposnik for their thoughtful comments. We agree that the relations between stroke and atrial fibrillation may be bidirectional and warrant further study. As the investigators mentioned, in some cases, stroke has been cited as a cause of atrial fibrillation. Clinical clues such as coronary artery disease status, cardiac dimensions and function, brain MRI imaging, and other characteristics of the stroke could also help in weighing the probability of whether atrial fibrillation detected after stroke is causal or a consequence of brain ischemia. We look forward to future results that might help distinguish the etiology of atrial fibrillation after a stroke, and inform patient management.
Acknowledgments
Disclosures: Dr. Lubitz has received consulting support from St. Jude Medical. Dr. Benjamin has received research funding from the National Institutes of Health and American Heart Association for work relating to the epidemiology of atrial fibrillation.
Footnotes
Journal Subject Codes: Atrial fibrillation; Ischemic Stroke; Cerebrovascular Disease/Stroke; Transient Ischemic Attack (TIA); Epidemiology