It was in 1847 that Virchow first reported occlusion of arteries in the brain by thrombi that seemed to have originated in the heart; he called this phenomenon embolism (from the Greek word 'embolus' which means plug), a term that would later be used to describe, in general, the occlusion of some part of the cardiovascular system by impaction of a foreign mass transported through the bloodstream to the site of occlusion. Over the following decades, in their attempt to understand the underlying pathogenesis of cerebral infarction, the medical profession focused primarily on the concept of local "thrombosis cerebri" as a consequence of atheromatous degeneration of the vessel walls with adherent thrombus formation. It was not until the seventies that embolism from the heart was again recognised as an important cause of ischaemic stroke. With the introduction of improved echocardiographic techniques, more and more cardiac disorders were identified and linked to the occurrence of cerebral ischaemia and today, as much as 10-20% of patients with acute cerebral ischaemia are found to have a cardiac abnormality that may potentially have caused their stroke. The commonest source of cardiac embolism is non-rheumatic atrial fibrillation, a dysrhythmia that affects 2-5% of the general population over the age of 60. This thesis aims to provide a better insight into the relationship between non-rheumatic atrial fibrillation and ischaemic stroke, and of the value of antithrombotic treatment in the prevention of thromboembolic events in patients with non-rheumatic atrial fibrillation.

F.G.A. van der Meché (Frans) , J. van Gijn (Jan)
Erasmus University Rotterdam
Dutch Heart Foundation, Bayer Germany (Wuppertal), Chest Heart and Stroke Foundation United Kingdom, University Hospital Dijkzigt Rotterdam, University Hospital Utrecht, Bayer, Sanofi Winthrop Nederland
Erasmus MC: University Medical Center Rotterdam

van Latum, J.C. (1995, January 4). European atrial fibrillation trial : secondary prevention in non-rheumatic atrial fibrillation. Erasmus University Rotterdam. Retrieved from