Asymptomatic cerebral infarction in patients with chronic atrial fibrillation.

A retrospective analysis of 54 patients with atrial fibrillation presenting with symptoms of cerebral ischemia between 1980 and 1985 was performed. Seven patients (13%) had computed tomographic evidence of previous, clinically silent cerebral infarction. In a control group of 168 persons (studied prospectively) in sinus rhythm presenting with symptoms of cerebral ischemia, seven (4%) had computed tomographic evidence of previous, clinically silent cerebral infarction (p less than 0.05). In those patients with atrial fibrillation all infarcts were peripheral and consistent with embolism, while in three of the seven patients in sinus rhythm the asymptomatic infarcts were lacunes.