Migraine and Atrial Fibrillation: A Systematic Review and Meta-analysis

Introduction: Patients with migraines, particularly those with auras, may present with stroke. Atrial fibrillation is a known risk factor for stroke. With common pathophysiological factors between migraines and atrial fibrillation, we aimed to clarify the association between migraine and atrial fibrillation in this systematic review and meta-analysis. Materials and Methods: A literature search was conducted in EMBASE, PubMed, Scopus and Cochrane electronic bibliographic databases from inception to 14th June 2021 with the following inclusion criteria: (1) cohort or cross-sectional studies, (2) patients ≥ 18-years-old, (3) studies examining association between atrial fibrillation and migraines. Exclusion criteria were case-control studies, studies including patients with prior diagnosis of atrial fibrillation or non-migrainous headache. The Newcastle Ottawa Scale was used to assess the quality of studies.  Results: 6 studies were included, demonstrating a 1.61% (95% CI 0.51, 3.29) pooled prevalence of atrial fibrillation in migraine with aura and 1.32% (95% CI 0.17, 3.41) in migraine without aura. The total prevalence of atrial fibrillation in migraine was 1.39% (95% CI 0.24, 3.46) overall. Conclusion: Overall, there was a higher prevalence of atrial fibrillation in migraine with aura compared to migraine without aura. Prevalence of atrial fibrillation in migraine patients was low.