Device-Detected Atrial Fibrillation What to Do With Asymptomatic Patients?

JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY

卷:65

Article

Chen-Scarabelli, Carol¹  Scarabelli, Tiziano M.²  Ellenbogen, Kenneth A.³  Halperin, Jonathan L.² 

[1] Univ Michigan, Vet Affairs Ann Arbor Hlth Care Syst, Ann Arbor, MI 48109 USA

[2] Icahn Sch Med Mt Sinai, Zena & Michael Wiener Cardiovasc Inst, New York, NY 10029 USA

[3] Virginia Commonwealth Univ, Dept Med, Sch Med, Richmond, VA 23298 USA

关键词: atrial tachyarrhythmias;    cardiac implantable electronic devices;    cerebral embolism;    defibrillator;    implantable cardiac monitor;    stroke;   

DOI  :  10.1016/j.jacc.2014.10.045

来源: Elsevier

【 摘 要 】

Atrial fibrillation (AF) is the most common clinically significant arrhythmia and conveys an increased risk of stroke, regardless of whether it is symptomatic. Despite multiple studies supporting an association between subclinical atrial tachyarrhythmias (ATs) detected by cardiac implantable electronic devices and increased risk of thromboembolic events, clinical intervention for device-detected AT remains sluggish, with some clinicians delaying treatment and instead opting for continued surveillance for additional or longer episodes. However, the 2014 updated clinical practice guidelines on AF recommend use of the CHA(2)DS(2)-VASc stroke risk score for nonvalvular AF, with oral anticoagulation recommended for scores >= 2, regardless of whether AF is paroxysmal, persistent, or permanent. This paper reviews the epidemiology of AF and mechanisms of stroke in AF, and discusses device-detected AF and its clinical implications. (C) 2015 by the American College of Cardiology Foundation.

【 授权许可】

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