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April 1, 2024European Heart Journal SupplementsOpen Access

Management of atrial arrhythmias identified by cardiac devices

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Key result

Anticoagulation for subclinical AF requires individualized assessment of duration and CHADSVASC given ~1% thromboembolic risk.

Why the study?

The clinical significance and appropriate therapeutic management of atrial high-rate events or subclinical atrial fibrillation detected by implantable devices remain incompletely defined, even after recent randomized trials.

Does anticoagulant therapy improve outcomes in patients with subclinical AF or AHREs identified by cardiac devices?

Population

Patients with atrial high-rate events or subclinical atrial fibrillation identified by implantable cardiac…

Design

Review

Authors

FSF StaziAzienda Ospedaliera San Giovanni Addolorata

Discussion

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Member takes

Overview

May warrant individualized anticoagulation decisions in device-detected subclinical AF; leaves open optimal thresholds pending randomized trials.

Key Points

  • To evaluate the management of atrial high-rate events and subclinical atrial fibrillation and their clinical implications.
  • Discussed findings from the NOAH-AFNET 6 and ARTESIA randomized studies.
  • Considered thrombo-embolic risk in patients with atrial high-rate events and subclinical AF.
  • Emphasized individual patient evaluations based on episode characteristics and CHADSVASC scores.
  • Average thrombo-embolic risk in patients with subclinical AF is approximately 1%.
  • Need for careful assessment before initiating anticoagulant therapy due to potential bleeding risks.
  • Suggest a quantitative approach to evaluate AHRE rather than a binary yes/no dichotomy.

Structured PICO

Does anticoagulant therapy improve outcomes in patients with subclinical AF or AHREs identified by cardiac devices?

P
Population
Patients with atrial high-rate events (AHREs) or subclinical atrial fibrillation identified by implantable cardiac devices
I
Intervention
Anticoagulant therapy

Anticoagulation for subclinical AF or AHREs requires individualized assessment of episode burden and CHA2DS2-VASc score due to a lower baseline thromboembolic risk compared to clinical AF.

Cite This Study

F Stazi (2024) conducted a review in Atrial high-rate events (AHREs) or subclinical atrial fibrillation. Anticoagulant therapy was evaluated. Anticoagulant therapy for subclinical atrial fibrillation requires individualized assessment of episode duration and CHADSVASC score, as the average thrombo-embolic risk is ~1%.

synapsesocial.com/papers/6a0ef7d325c30b2cc7f9fbc9https://doi.org/10.1093/eurheartjsupp/suae029
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Atrial High-Rate Episodes and Subclinical Atrial Fibrillation: State of the Art and Clinical Questions with Complex Solutions2024 · 5 citations
  2. 2Antithrombotic therapy in patients with atrial high-rate episodes (AHREs): Current evidence and open questions2024 · 8 citations
  3. 3Management of Device Detected Subclinical Atrial Fibrillation2024
  4. 4What do we do about atrial high rate episodes?2020 · 44 citations
  5. 5Subclinical Atrial Fibrillation and Anticoagulation: Weighing the Absolute Risks and Benefits2024 · 13 citations