Device-detected atrial fibrillation: What to do with asymptomatic patients?

Carol Chen-Scarabelli, Tiziano M. Scarabelli, Kenneth A. Ellenbogen, Jonathan L. Halperin

Research output: Contribution to journalReview articlepeer-review

48 Scopus citations

Abstract

Atrial fibrillation (AF) is the most common clinically significant arrhythmia and conveys an increased risk of stroke, regardless of whether it is symptomatic. Despite multiple studies supporting an association between subclinical atrial tachyarrhythmias (ATs) detected by cardiac implantable electronic devices and increased risk of thromboembolic events, clinical intervention for device-detected AT remains sluggish, with some clinicians delaying treatment and instead opting for continued surveillance for additional or longer episodes. However, the 2014 updated clinical practice guidelines on AF recommend use of the CHA2DS2-VASc stroke risk score for nonvalvular AF, with oral anticoagulation recommended for scores ≥2, regardless of whether AF is paroxysmal, persistent, or permanent. This paper reviews the epidemiology of AF and mechanisms of stroke in AF, and discusses device-detected AF and its clinical implications.

Original languageEnglish
Pages (from-to)281-294
Number of pages14
JournalJournal of the American College of Cardiology
Volume65
Issue number3
DOIs
StatePublished - 27 Jan 2015

Keywords

  • atrial tachyarrhythmias
  • cardiac implantable electronic devices
  • cerebral embolism
  • defibrillator
  • implantable cardiac monitor
  • stroke

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