ABSTRACT NUMBER: ESOC2026LB154 CO-OCCURRENCE OF NONSUSTAINED VENTRICULAR TACHYCARDIA AND ATRIAL FIBRILLATION AFTER MAJOR CEREBROVASCULAR EVENTS

Abstract Background and aims Nonsustained ventricular tachycardia (NSVT) is considered benign, but emerging data suggest its prognostic and mechanistic significance in stroke survivors. NSVT in post-stroke populations is well-documented, but its relationship to occult atrial fibrillation or flutter (AF) –a major stroke risk factor– in this contex remains poorly understood. Here, we explore the co-existence of NSVT and occult AF after major cerebrovascular events and delineate patient profiles. Methods We conducted a retrospective review of patients at an academic medical centre with NSVT and occult AF after high-risk transient ischaemic attack (TIA) or acute ischaemic stroke (AIS) between 2020 and 2025. All had 30-day or longer ambulatory telemetry. Results The cohort comprised 10 patients aged 40 years and above; six men, four women. All had hyperlipidemia, nine (90%) had significant structural heart changes, and nine (90%) had hypertension. NSVT was detected before AF in nine patients (90%). Time from TIA or stroke to AF detection was 13 days to seven years (median ~10 months). AF was typically captured on ambulatory telemetry with an external monitor or implanted recorder, not inpatient telemetry or outpatient Holter monitors two weeks or shorter. Conclusions This study proposes that NSVT after TIA or stroke may indicate cardiac electrical instability associated with AF in some patients. Our data suggest AF-associated NSVT after major cerebrovascular events may be more likely with structural heart changes, hypertension and hyperlipidemia. Larger studies are needed to characterise NSVT after TIA or stroke, determine its relationship to occult AF and understand its implications for secondary prevention. Conflict of interest