[4:51 pm, 25/11/2025] cm: @hu2 there are 50 patients of cardiac arrhythmias in this archived patient EMR summaries from Narketpally 👇
As a first step, would it be possible for you to run a thematic analysis of this data through multiple LLMs and share the emerging themes?
[10:54 am, 26/11/2025] hu2: Unfortunately we have 1st to make it into 2 parts, each one of 25, then LLM would handle it with pleasure 🙏
[10:58 am, 26/11/2025] cm: Alright. @hu3 please divide the cases into two blogs of 25 each.
[11:04 am, 26/11/2025] hu3: Ok sir
[1:53 pm, 26/11/2025] hu4: What would be the risk of stroke (ischemic)? Persistent AFib with LVSD should put this at high risk?
[1:58 pm, 26/11/2025] hu4: Sorry, looks like more RV dysfunction, any indication of poor filling in RV?
[4:12 pm, 26/11/2025] cm: Is this question in relation to any of the 59 cases here or a question im general?
[5:52 pm, 26/11/2025] hu4: The one labelled case no 1 as am crawling through.
[6:53 pm, 26/11/2025] cm: 👆@hu3 this question is for case 1. Please answer
[6:59 pm, 26/11/2025] hu3: Stroke risk assessment
Given the clinical profile you’ve outlined, the key stroke‑risk determinant is the presence of atrial fibrillation (AF) combined with significant left‑ventricular systolic dysfunction (LVSD, EF ≈ 20 %).
- CHA₂DS₂‑VASc score is the standard tool for estimating ischemic stroke risk in AF. Typical scoring for this patient would be:
- C (Congestive heart failure / LVSD) = 1 point
- H (Hypertension) – assume present if part of the ACS/heart‑failure picture = 1 point
- A (Age ≥ 75 y) – unknown from your note, but if ≥ 75 add 2 points (or 1 point for age 65‑74)
- D (Diabetes) – unknown, add 1 point if present
- S (Stroke/TIA/thrombo‑embolism history) – none mentioned = 0 points
- V (vascular disease – prior MI, PAD, or aortic plaque) = 1 point (ACS/NSTEMI qualifies)
- Sc (Sex category – female) = 1 point if female.
Assuming the patient is male and < 65 years (if those details aren’t provided), the score would be ≥ 3 (1 + 1 + 1 + 0 + 0 + 0 + 0 = 3). If the patient is older or female, the score could easily climb to 4–5, placing him/her in a high‑risk category (annual stroke risk ~4–10 % without anticoagulation).
Bottom line:
- Persistent atrial fibrillation plus severe LV systolic dysfunction (EF 20 %) puts this patient at high risk for ischemic stroke.
- Formal anticoagulation (typically with a DOAC or warfarin, barring contraindications) is generally indicated for CHA₂DS₂‑VASc ≥ 2 in men and ≥ 3 in women.
[7:15 pm, 26/11/2025] cm: Case 1 D. O. D was 13/03/2024? Any follow up? How long did he continue the rivoroxaban?
[7:22 pm, 26/11/2025] hu3: Yes sir, he continued for next 3 months
[7:30 pm, 26/11/2025] cm: That would be till June 2024? Did his stroke risk reduce after that or he was lost to follow up?
[7:38 pm, 26/11/2025] hu3: Stroke risk reduced sir
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