Arrhythmias & electrophysiology
Atrial fibrillation and atherosclerosis cause different vascular brain lesions on magnetic resonance imaging
Authors' conclusion
Patients with AF had a higher rate of non-lacunar infarcts, multi-infarct patterns and more severe periventricular white matter disease compared with patients with atherosclerosis.
Study context
- Population
- Patients with atrial fibrillation (AF) or atherosclerosis with standardized brain magnetic resonance imaging (MRI)
- Participants
- 3,508 patients
- Exposure
- AF vs atherosclerosis without AF
- AFn = 1,748
- Atherosclerosisn = 1,760reference
- Outcome
- Prevalence of lacunar and non-lacunar infarcts, periventricular and deep WMH, and cerebral microbleeds on MRI
Methodological detailscomparison of two cohorts (Swiss-AF and COMPASS MIND), standardized brain MRI
- Comparison of two cohorts (Swiss-AF and COMPASS MIND)
- Standardized brain MRI
Main finding
As reported in the abstract
Vascular brain lesions on MRI
AF
- Non-lacunar infarcts
- 22%
- Lacunar infarcts
- 21%
- Higher grade periventricular white matter hyperintensities (WMH)
- 49%
- Cerebral micro-bleeds (CMB)
- 22%
Atherosclerosis
- Non-lacunar infarcts
- 10%
- Lacunar infarcts
- 26%
- Higher grade periventricular WMH
- 37%
- CMB
- 29%
Non-lacunar infarcts
AF22%
Atherosclerosis10%
Lacunar infarcts
AF21%
Atherosclerosis26%
Higher grade periventricular white matter hyperintensities (WMH)
AF49%
Atherosclerosis37%
Cerebral micro-bleeds (CMB)
AF22%
Atherosclerosis29%
AF vs AtherosclerosisOdds ratio (95% CI)P value
Non-lacunar infarcts, multivariable
2.28(1.86–2.81)
P < 0.001Lacunar infarcts, multivariable
0.66(0.56–0.79)
P < 0.001Severe periventricular WMH, multivariable
1.42(1.22–1.67)
P < 0.001Observational data: associations, not effects.
Original publication
Atrial fibrillation and atherosclerosis cause different vascular brain lesions on magnetic resonance imaging. Eur Heart J. Published 29 August 2025. doi:10.
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