Subclinical and Device-Detected Atrial Fibrillation: Pondering the Knowledge Gap: A Scientific Statement From the American Heart Association

Peter A Noseworthy, Elizabeth S Kaufman, Lin Y Chen, Mina K Chung, Mitchell S V Elkind, José A Joglar, Miguel A Leal, Pamela J McCabe, Sean D Pokorney, Xiaoxi Yao
Circulation 2019 December 17, 140 (25): e944-e963
The widespread use of cardiac implantable electronic devices and wearable monitors has led to the detection of subclinical atrial fibrillation in a substantial proportion of patients. There is evidence that these asymptomatic arrhythmias are associated with increased risk of stroke. Thus, detection of subclinical atrial fibrillation may offer an opportunity to reduce stroke risk by initiating anticoagulation. However, it is unknown whether long-term anticoagulation is warranted and in what populations. This scientific statement explores the existing data on the prevalence, clinical significance, and management of subclinical atrial fibrillation and identifies current gaps in knowledge and areas of controversy and consensus.

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