Silent AF is underdiagnosed and carries similar morbidity and mortality to symptomatic AF, though it remains to be demonstrated if increased detection improves patient outcomes.
Silent AF underdiagnosis in stroke patients leaves open optimal screening strategies; supports further detection research without practice change.
In recent years, silent atrial fibrillation (AF) has acquired broad interest in the neurologic and cardiovascular communities. Silent AF has been associated with similar morbidity and mortality as symptomatic AF and with similar rates of silent embolic events. In current clinical practice, AF remains mostly underdiagnosed, and 25% of patients with AF-associated cardioembolic stroke have not been previously diagnosed with AF. Silent AF detection methods include pulse palpation, ambulatory external electrocardiographic recordings, insertable cardiac monitors, and previously implanted cardiac devices with atrial lead. The increased interest is being directed toward detection of silent AF. Whether this will imply better outcomes for patients remains to be demonstrated.
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Aksoy et al. (2016) studied this question.
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