Stroke of Cardioembolic Origin: What We Have Learnt in the Past 10 Years?

Abstract

Cerebral infarctions of cardioembolic origin are usually large lesions and clinically severe conditions. Cardioembolic stroke is the most frequent ischemic infarction in very old subjects. The diagnosis has largely improved due to generalization of echocardiography in daily practice, the use of 24-h Holter monitoring, transcranial Doppler ultrasound and modern neuroimaging advances, as well as the development of specific biological markers. Vascular repermeabilization using thrombolytic treatment in selected patients has improved the prognosis, and new oral anticoagulants with a higher safety profile and a non-inferior or superior efficacy as compared to coumarin are important additions in the therapeutic armamentarium for preventing cardioembolic events in patients with non-valvular atrial fibillation. Some clinical research lines remain open, such as genetic-related risk of atrial fibrillation.