THURSDAY, Oct. 22, 2026 (HealthDay News) -- For patients with atrial fibrillation (AF) and acute ischemic stroke, early initiation of rhythm control is associated with a lower risk for recurrent stroke or systemic embolism (SE), according to a study published online Oct. 21 in Neurology.
Shuhei Egashira, M.D., from Kyoto University in Japan, and colleagues examined whether early rhythm control after acute ischemic stroke is associated with a lower risk for recurrent stroke or SE in patients with AF in a nationwide cohort study. The exposure examined was initiation of rhythm control (antiarrhythmic drugs, catheter ablation, or electrical cardioversion) within eight weeks of admission versus no initiation (usual care).
Overall, 1.9 percent of the 14,355 patients who survived event-free through the eight-week landmark received early rhythm control. The researchers found that early rhythm control was associated with a lower risk for stroke/SE during 23,583 person-years (hazard ratio, 0.56; weighted five-year cumulative incidence, 8.0 versus 13.8 percent). No association was seen with major bleeding or heart failure hospitalizations. There was an association for early rhythm control with lower all-cause mortality (hazard ratio, 0.72). Across landmark periods of four to 24 weeks, results were consistent.
"People who have an ischemic stroke are prescribed anticoagulants, medications that stop the blood from clotting easily, to prevent a second stroke," coauthor Yuichi Imanaka, M.D., M.P.H., also from Kyoto University, said in a statement. "Our study suggests that early rhythm control may serve as another prevention strategy, with flexible timing of initiation, within eight weeks of stroke."
Two authors disclosed ties to the biopharmaceutical industry.
