Which cardiac rhythm is commonly associated with strokes due to emboli?

• A. Atrial fibrillation
• B. sinus arrhythmia
• C. Functional bradycardia
• D. Sinus rhythm with PAC

Answer: (A)

Atrial fibrillation creates a situation where the atria don’t contract effectively, leading to blood pooling and clot formation in the left atrium, especially in the left atrial appendage. When a clot breaks free, it can travel through the bloodstream to the brain and block a cerebral artery, causing an ischemic stroke. This mechanism makes atrial fibrillation the rhythm most commonly linked to embolic strokes.

Other rhythms described—such as sinus arrhythmia, functional bradycardia, or sinus rhythm with premature atrial contractions—don’t consistently produce the same dangerous blood stasis and thrombus formation seen with atrial fibrillation, so they aren’t typically associated with embolic strokes. In practice, recognizing AF is important because anticoagulation is often used to reduce stroke risk, guided by risk scores like CHA2DS2-VASc.