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May 31, 2023Terapevticheskii arkhivOpen Access

Tactics of anticoagulant therapy in patients with cardiac implantable electronic devices and subclinical atrial fibrillation: A review

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Key result

CIED-detected subclinical AF links to higher thromboembolic risk, but optimal anticoagulation remains unresolved.

Why the study?

The risk of thromboembolic events varies between patients with subclinical atrial fibrillation (SCAF) and clinically overt AF, leaving the role of anticoagulant therapy in SCAF unresolved.

Does anticoagulant therapy prevent thromboembolic events in patients with cardiac implantable electronic devices and subclinical atrial fibrillation?

Population

Patients with CIEDs and subclinical atrial fibrillation

Design

Review

Authors

TRTatiana V. RazinaMSMaria SerovaДАД. А. Андреев

Discussion

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Overview

Anticoagulation decisions for CIED-detected subclinical AF should remain individualized; leaves open optimal thresholds pending dedicated RCTs.

Structured PICO

Does anticoagulant therapy prevent thromboembolic events in patients with cardiac implantable electronic devices and subclinical atrial fibrillation?

P
Population
Patients with cardiac implantable electronic devices (CIEDs) and subclinical atrial fibrillation (SCAF)
I
Intervention
Anticoagulant therapy
O
Outcome
Thromboembolic events (stroke)

This review highlights that while subclinical AF detected by CIEDs increases thromboembolic risk, routine anticoagulation is currently only considered for longer episodes (e.g., >24 hours) or high-risk patients, pending definitive trial data.

Limitations

  • Lack of randomized controlled trials on the efficacy and safety of anticoagulant therapy in patients with subclinical atrial fibrillation
  • Heterogeneity in the definition and detection criteria of atrial high-rate episodes across studies

Cite This Study

Razina et al. (2023) conducted a review in Subclinical atrial fibrillation in patients with cardiac implantable electronic devices. Anticoagulant therapy was evaluated. Subclinical atrial fibrillation detected by cardiac implantable electronic devices is associated with an increased risk of thromboembolic events, but the optimal strategy for anticoagulant therapy remains unresolved.

synapsesocial.com/papers/6a154e47b03a896dfa82080fhttps://doi.org/10.26442/00403660.2023.04.202189
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Also Consider

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

  1. 1Impact of Atrial Fibrillation on the Risk of Death1998 · 4,612 citations
  2. 2Clinical Implications of Brief Device-Detected Atrial Tachyarrhythmias in a Cardiac Rhythm Management Device Population2016 · 157 citations
  3. 3Incidence of Previously Undiagnosed Atrial Fibrillation Using Insertable Cardiac Monitors in a High-Risk Population2017 · 265 citations
  4. 4Practice Variation in Anticoagulation Prescription and Outcomes After Device-Detected Atrial Fibrillation2019 · 105 citations
  5. 5EFFICACY OF ATRIAL FIBRILLATION DETECTION IN CRYPTOGENIC STROKE ACCORDING TO DATA OF IMPLANTABLE LOOP RECORDERS: PILOT STUDY2019 · 3 citations