Patients with normal heart rhythms but weak atrial contraction face high stroke risk, suggesting need for anticoagulants.

A new study presented at the American Heart Association's 2025 Scientific Sessions finds that people with transthyretin amyloid cardiomyopathy (ATTR-CM) who have normal heart rhythms but poor atrial contraction—measured by a condition called atrial electromechanical dissociation (AEMD)—face a significantly higher stroke risk, with nearly 9% experiencing a stroke or TIA annually. The research, based on over 2,300 patients, suggests that assessing atrial function, not just rhythm, could help identify high-risk individuals who may benefit from preventive treatments like anticoagulants, even without atrial fibrillation. However, the study is observational and limited to one center, and the diagnostic tool used is not widely available. Experts call for larger, prospective trials to confirm the findings and determine if anticoagulation reduces stroke risk in this group.