“Asymptomatic” persistent or permanent atrial fibrillation: A misnomer in selected patients

Ganapathy, Anand V.; Monjazeb, Seena; Ganapathy, Krithika S; Shanoon, Farah; Razavi, Mehdi

doi:10.1016/j.ijcard.2015.03.122

Cited by 17 publications

(12 citation statements)

References 10 publications

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“…Atrial fibrillation (AF) represents one of the most diagnosed supraventricular arrhythmia and its prevalence has been estimated to be 1-2% of the general population, with a progressive increase over the next few decades (1). However, prevalence data of AF could have been underestimated due to the evidence that up to 40% of AF patients are asymptomatic (2).…”

Section: Introductionmentioning

confidence: 99%

Asymptomatic versus symptomatic atrial fibrillation: A systematic review of age/gender differences and cardiovascular outcomes

Xiong

Proietti

Senoo

et al. 2015

International Journal of Cardiology

136

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Up to 40% of atrial fibrillation (AF) patients are asymptomatic. Despite this, scarce data are available about asymptomatic AF, with regard to its clinical profile and relationship to cerebrovascular and cardiovascular risks. Our objective was to conduct a systematic review and meta-analysis was to study the relationship between age and gender with asymptomatic AF and to establish whether patients with asymptomatic AF have a higher risk of death (all-cause and cardiovascular) and stroke/systemic thromboembolism, when compared to symptomatic AF patients. After a comprehensive search, 6 studies (2 randomized clinical trials and 4 observational studies) were entered in the meta-analysis. Despite significant heterogeneity, our data show that the prevalence of females amongst asymptomatic AF group was significantly less compared to the symptomatic AF group (RR, 0.57; 95% CI: 0.52-0.64). No difference in age between asymptomatic and symptomatic AF patients (P=0.72) was seen. No differences were found in all-cause death between patients with asymptomatic and symptomatic AF (RR, 1.38; 95% CI: 0.82-2.17), nor in cardiovascular death (RR, 0.85; 95% CI: 0.53-1.36) or stroke/thromboembolism (RR, 1.72 95% CI: 0.59-5.08). Asymptomatic AF is more associated with male sex, irrespective of age. Both general and cardiovascular death risks as well as thromboembolic risk do not seem to be affected by the asymptomatic clinical status. Symptomatic status should not determine our approach to stroke prevention and other cardiovascular prevention therapies, amongst patients with AF.

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Section: Introductionmentioning

confidence: 99%

Asymptomatic versus symptomatic atrial fibrillation: A systematic review of age/gender differences and cardiovascular outcomes

Xiong

Proietti

Senoo

et al. 2015

International Journal of Cardiology

136

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“…A key issue in the management of patients without symptoms while remaining in AF is the exclusion of a pseudo-asymptomatic status. Up to 77% of these patients may experience subjective symptomatic amelioration, 323 improvement in functional class, and decrease in brain natriuretic peptide levels with SR restoration following electrical cardioversion. 324 Therefore, in asymptomatic patients, especially at younger age, a cardioversion is worth attempting to assess potential symptomatic improvement that would enhance patient eligibility for catheter ablation due to reclassification in the symptomatic category.…”

Section: Indications For Catheter Ablation Of Atrial Fibrillationmentioning

confidence: 99%

2024 European Heart Rhythm Association/Heart Rhythm Society/Asia Pacific Heart Rhythm Society/Latin American Heart Rhythm Society expert consensus statement on catheter and surgical ablation of atrial fibrillation

Tzeis,

Gerstenfeld,

Kalman

et al. 2024

Europace

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In the last three decades, ablation of atrial fibrillation (AF) has become an evidence-based safe and efficacious treatment for managing the most common cardiac arrhythmia. In 2007, the first joint expert consensus document was issued, guiding healthcare professionals involved in catheter or surgical AF ablation. Mounting research evidence and technological advances have resulted in a rapidly changing landscape in the field of catheter and surgical AF ablation, thus stressing the need for regularly updated versions of this partnership which were issued in 2012 and 2017. Seven years after the last consensus, an updated document was considered necessary to define a contemporary framework for selection and management of patients considered for or undergoing catheter or surgical AF ablation. This consensus is a joint effort from collaborating cardiac electrophysiology societies, namely the European Heart Rhythm Association, the Heart Rhythm Society, the Asia Pacific Heart Rhythm Society, and the Latin American Heart Rhythm Society .

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“…in ihrer Studie. In dieser Analyse stellt sich einerseits heraus, dass 75 % der asymptomatischen VHF-Patienten nach einer elektrischen Kardioversion einen positiven Unterschied empfunden haben [15]. Andererseits hatten 624 Patienten mit persistierendem VHF im Rahmen der SAFE-T-Studie (davon 41 % asymptomatisch) 1 Jahr nach der Kardioversion keine wesentliche Veränderung bezüglich der Lebensqualität bemerkt [16].…”

Section: Rolle Der Elektrischen Kardioversionunclassified

Katheterablation bei asymptomatischem Vorhofflimmern – Wer profitiert?

Hindricks

Darma

2021

Aktuelle Kardiologie

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ZusammenfassungDie Katheterablation von paroxysmalem oder persistierendem Vorhofflimmern hat sich in den letzten Jahren als überlegene Therapiebehandlung zur Rhythmusstabilisierung gegenüber Antiarrhythmika etabliert. Allerdings wird diese Behandlung nach den aktuellen Leitlinien nur bei symptomatischen Patienten empfohlen. Ein großer Teil der Vorhofflimmerpatienten bleibt jedoch asymptomatisch. Ältere Studien konnten keinen Vorteil bezüglich der Letalitäts- oder Apoplexreduktion durch Rhythmusstabilisierung nachweisen. Eine aktuelle randomisierte Studie zeigt erstmalig eine Reduktion der kardiovaskulären Ereignisse, aber nicht der Gesamtletalität. Ist nach aktueller Datenlage eine Katheterablation im Falle von asymptomatischen Patienten berechtigt und wer könnte davon profitieren?

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“Asymptomatic” persistent or permanent atrial fibrillation: A misnomer in selected patients

Cited by 17 publications

References 10 publications

Asymptomatic versus symptomatic atrial fibrillation: A systematic review of age/gender differences and cardiovascular outcomes

Asymptomatic versus symptomatic atrial fibrillation: A systematic review of age/gender differences and cardiovascular outcomes

2024 European Heart Rhythm Association/Heart Rhythm Society/Asia Pacific Heart Rhythm Society/Latin American Heart Rhythm Society expert consensus statement on catheter and surgical ablation of atrial fibrillation

Katheterablation bei asymptomatischem Vorhofflimmern – Wer profitiert?

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