Arrhythmias & electrophysiologyCross-sectional study
Atrial fibrillation and atherosclerosis cause different vascular brain lesions on magnetic resonance imaging
- Cross-sectional study
- comparison of two cohorts (Swiss-AF and COMPASS MIND)
- standardized brain magnetic resonance imaging (MRI)
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 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
Main finding
As reported in the abstract
Vascular brain lesions on MRI
AF
22%
Non-lacunar infarcts · Lacunar infarcts 21% · Higher grade periventricular white matter hyperintensities (WMH) 49% · cerebral micro-bleeds (CMB) 22%
Atherosclerosis
10%
Non-lacunar infarcts · Lacunar infarcts 26% · Higher grade periventricular WMH 37% · CMB 29%
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:10.1093/eurheartj/ehaf550
Summarised from the published abstract; every number is checked against it