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Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response.  Labels: BACKGROUND, METHODS, RESULTS. Meshes: Adult, Aged, Aged, 80 and over, Atrial Fibrillation, Bradycardia, Brain Ischemia, Case-Control Studies, Colitis, Ischemic, Electrocardiography, Extremities, Female, Follow-Up Studies, Humans, Infarction, Ischemia, Kidney, Male, Middle Aged, Pulmonary Embolism, Retrospective Studies, Risk Factors, Stroke, Thromboembolism.
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Is junctional bradycardia a potential risk factor of stroke? Context: This study aimed to determine the risk of thromboembolic events in patients with junctional bradycardia(JB). We retrospectively reviewed electrocardiograms(ECGs) for 380,682 patients. Those with JB on an ECG at least twice over a ≥3-month interval were included for analysis. We additionally included 138 CHADS2 score-matched patients(age, 68.4 ± 15.7 years; male, 52.2%) in sinus rhythm as a control group. Between the JB patients(with or without retrograde P wave) and controls, we compared incidences of ischemic stroke and a composite of ischemic stroke, renal infarction, ischemic colitis, acute limb ischemia, and pulmonary embolism. Among 380,682 patients (age, 47.6 ± 19.9 years; male, 49.3%), 69 patients (age, 68.5 ± 16.5 years; male, 50.7%) exhibited JB on an ECG at least twice over a ≥3-month interval; the overall prevalence of JB was 0.02%. The mean follow-up period was 27.2 ± 26.2 months. Forty-five patients (65.2%) in the JB group had no retrograde P wave. Ischemic stroke incidence was significantly higher in JB patients without a retrograde P wave than in controls (6/45 patients [13.3%] and 3/138 patients [2.2%], respectively; P = 0.007). The incidence of composite thromboembolic events was also significantly higher in JB patients without a retrograde P wave than in controls (8/45 patients [17.8%] and 4/138 patients [2.9%], respectively; P = 0.011). In a Cox proportional hazards model, JB patients without a P wave showed a greater incidence of stroke (hazard ratio, 8.89 [2.20-33.01], P = 0.007) than controls and JB patients with a P wave.
assistant
Junctional bradycardia is potentially associated with ischemic stroke, particularly in the absence of an identifiable retrograde P wave. Final Decision: yes