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March 25, 2024CirculationOpen Access

Therapeutic anticoagulation shows unclear risk-benefit in device-detected AF due to low stroke and bleeding rates.

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Why the study?

Whether the absolute risk-benefit favors anticoagulation in patients with only device-detected atrial fibrillation who lack clinically documented atrial fibrillation remains unclear.

Does therapeutic anticoagulation reduce ischemic stroke risk without excessive bleeding in patients with device-detected subclinical AF?

Population

Patients with device-detected subclinical atrial fibrillation (AF) or atrial high-rate episodes

Design

Editorial

Key result

The absolute risk-benefit of therapeutic anticoagulation in patients with only device-detected atrial fibrillation remains unclear due to lower absolute rates of ischemic stroke and bleeding risks.

Authors

SPSiddharth M. PatelCRChristian T. Ruff

Discussion

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Member takes

Overview

Device-detected subclinical AF episodes complicate risk stratification; leaves open anticoagulation thresholds for short-duration events.

Structured PICO

Does therapeutic anticoagulation reduce ischemic stroke risk without excessive bleeding in patients with device-detected subclinical AF?

P
Population
Patients with device-detected subclinical atrial fibrillation (AF) or atrial high-rate episodes
I
Intervention
Therapeutic anticoagulation (direct oral anticoagulants [DOACs])
O
Outcome
Ischemic stroke

The optimal management of subclinical device-detected AF remains uncertain, as the lower absolute risk of stroke must be weighed against the bleeding risks of anticoagulation.

Cite This Study

Patel et al. (2024) conducted a review in Subclinical Atrial Fibrillation. Anticoagulation was evaluated. The absolute risk-benefit of therapeutic anticoagulation in patients with only device-detected atrial fibrillation remains unclear due to lower absolute rates of ischemic stroke and bleeding risks.

synapsesocial.com/papers/6a4c42b6028ea97264ab773chttps://doi.org/10.1161/circulationaha.123.067919
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Also Consider

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

  1. 1Device-Detected Atrial Fibrillation2015 · 55 citations
  2. 2Device-Detected Atrial Fibrillation: Why Time-Based Thresholds Are No Longer Fit for Purpose2026
  3. 3Subclinical Atrial Tachyarrhythmias:Implantable Devices and Remote Monitoring.2015 · 7 citations
  4. 4Subclinical and Device-Detected Atrial Fibrillation: Pondering the Knowledge Gap: A Scientific Statement From the American Heart Association2019 · 171 citations
  5. 5Management of atrial arrhythmias identified by cardiac devices2024