Oh Kyungmi, Choi Jeong-Yoon, Kim Byung-Jo
Department of Neurology, Korea University Medical Center, Korea University College of Medicine, Seoul, Korea.
J Korean Neurosurg Soc. 2013 Jun;53(6):368-70. doi: 10.3340/jkns.2013.53.6.368. Epub 2013 Jun 30.
Post-stroke atrial fibrillation has been frequently reported especially in the patients with right insular infarct as an evidence of cerebrogenic mechanism affecting on cardiac rhythm. However, conversion to normal sinus rhythm after stroke in patients who had atrial fibrillation has not been reported. A 88-year-old men who had untreated atrial fibrillation was admitted to hospital due to left middle cerebral artery territory infarction. During admission, second ischemic attack occurred in right middle cerebral artery territory. At that time, his atrial fibrillation converted spontaneously to normal sinus rhythm. Restored sinus rhythm sustained until he died due to sepsis. This case is evidence supporting a theory that brain is associated with control of cardiac rhythm. If no risk factor is revealed by intensive investigation in patients with acute cerebral infarctions that cardioembolism is strongly suspected as a cause, physicians should concern transformation of atrial fibrillation to normal sinus rhythm after stroke.
卒中后房颤屡有报道，尤其是在右岛叶梗死患者中，这是影响心律的脑源性机制的一个证据。然而，房颤患者卒中后转为正常窦性心律的情况尚未见报道。一名88岁未治疗房颤男性因左侧大脑中动脉供血区梗死入院。住院期间，右侧大脑中动脉供血区发生了第二次缺血性发作。此时，他的房颤自发转为正常窦性心律。恢复的窦性心律一直维持到他因败血症死亡。该病例支持了大脑与心律控制有关这一理论。对于急性脑梗死且高度怀疑心源性栓塞为病因但经深入检查未发现危险因素的患者，医生应关注卒中后房颤转为正常窦性心律的情况。
