Key result
Wearables and implantables detect subclinical AF but risk overdiagnosis in healthy populations.
Why the study?
Uncertainties remain regarding anticoagulation for subclinical atrial fibrillation detected by cardiac implantable electronic devices, while wearable devices introduce new opportunities and challenges in AF detection.
This review highlights the opportunities and challenges of using implantable and wearable devices for detecting subclinical atrial fibrillation, emphasizing the need to balance diagnostic utility with the risk of overdiagnosis.
May support targeted device screening in high-risk patients; leaves open net benefit and management thresholds for subclinical detections.
This mini review lists available data on detection of subclinical atrial fibrillation (SCAF) in patients with cardiac implantable electronic devices and underlines uncertainties that remain when it comes to anticoagulation. Ongoing trials will examine the benefit of anticoagulation in these patients when SCAF duration is in the grey zone between 5–6 minutes and 24 hours. Meanwhile, smart and wearable devices may lead to a more patient-driven than physician-driven diagnostic in detection of AF. Wearables come with opportunities and challenges and cardiologists will need to focus on the right balance between using wearables as an additional diagnostic tool in patients at risk while avoiding overdiagnosis in the healthy general population.
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Berg et al. (2021) conducted a review in Subclinical atrial fibrillation (SCAF). Implantable and wearable devices was evaluated. Implantable and wearable devices offer new opportunities for detecting subclinical atrial fibrillation, but require balancing diagnostic utility against the risk of overdiagnosis in healthy populations.
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