Device-detected subclinical atrial tachyarrhythmias: definition, implications and management—an European Heart Rhythm Association (EHRA) consensus document, endorsed by Heart Rhythm Society (HRS), Asia Pacific Heart Rhythm Society (APHRS) and Sociedad Latinoamericana de Estimulación Cardíaca y Electrofisiología (SOLEACE)

Görenek, Bülent; Bax, Jeroen J.; Boriani, Giuseppe; Chen, Shih‐Ann; Dagres, Nikolaos; Glotzer, Taya V.; Healey, Jeff S.; Israel, Carsten W.; Kudaiberdieva, Gulmira; Levin, Lars‐Åke; Lip, Gregory Y.H.; Martin, David T.; Okumura, Ken; Svendsen, Jesper Hastrup; Tse, Hung‐Fat; Botto, Giovanni Luca; Sticherling, Christian; Linde, Cecilia; Kutyifa, Valentina; Bernat, Robert; Scherr, Douglas S.; Lau, Chu‐Pak; Iturralde, Pedro; Morin, Daniel P.; Savelieva, Irina

doi:10.1093/europace/eux163

Cited by 194 publications

(101 citation statements)

References 114 publications

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“…We definitely agree with the authors' statement that routine use of implantable loop recorders in patients with cryptogenic stroke should be based on randomized prospective studies and is not yet unrestrictedly recommended in the cited recent consensus document [1]. However, we are convinced that the observational data currently available is promising and may even allow prediction of atrial fibrillation before it is detected.…”

Section: Sirssupporting

confidence: 61%

Reply to letter to the editor by Gulmira Kudaibedieva and Bulent Gorenek

2019

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Section: Sirssupporting

confidence: 61%

Reply to letter to the editor by Gulmira Kudaibedieva and Bulent Gorenek

2019

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“…Studies have demonstrated that device-detected episodes of AF ranging in duration from 5 min to 24 h are associated with increased risk of stroke, with the clearest evidence for an increased risk for episodes of 24 h or more. 19 A recent consensus document has recommended initiation of OAC in appropriate device patients with >5.5 h of daily AF burden, 20 while others have suggested shorter and longer AF durations dependent on a patient's underlying risk for stroke. 21 Regardless of the actual cut-off used, our data demonstrate that AT/AF is common and steadily increases over time.…”

Section: Discussionmentioning

confidence: 99%

Estimating the incidence of atrial fibrillation in single‐chamber implantable cardioverter defibrillator patients

Zweibel

Cronin

Schloss

et al. 2018

Pacing Clinical Electrophis

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Background Atrial arrhythmias are associated with major adverse cardiovascular events. Recent reports among implantable cardioverter defibrillator (ICD) patients have demonstrated a high prevalence of atrial fibrillation (AF), predominantly in dual‐chamber recipients. AF incidence among patients with single‐chamber systems (approximately 50% of all ICDs) is currently unknown. The objective was to estimate the prevalence of new‐onset AF among single‐chamber ICD patients by observing the rates of new atrial tachycardia (AT)/AF among a propensity scoring matched cohort of dual‐chamber ICD patients from the PainFree SmartShock technology study, to better inform screening initiatives. Methods Among 2770 patients enrolled, 1862 single‐chamber, dual‐chamber, and cardiac resynchronization therapy subjects with no prior history of atrial tachyarrhythmias were included. Daily AT/AF burden was estimated using a propensity score weighted model against data from dual‐chamber ICDs. Results Over 22 ± 9 months of follow‐up, the estimated incidence of AT/AF—lasting at least 6 min, 6 h, and 24 h per day —in the single‐chamber cohort was 22.0, 9.8, and 6.3%, whereas among dual‐chamber patients, the prevalence was 26.6, 13.1, and 7.1%, respectively. Initiation of oral anticoagulation was estimated to occur in 9.8% of the propensity matched single‐chamber cohort, which was higher than the actual observed rate of 6.0%. Stroke and transient ischemic attack occurred at low rates in all device subgroups. Conclusions Atrial arrhythmias occur frequently, and significant underutilization of anticoagulation is suggested in single‐chamber ICD recipients. Routine screening for AF should be considered among single‐chamber ICD recipients.

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“…11 Several episodes of high atrial rate were detected by the ICM, which can be used for detection of AF. 12 Despite limited evidence of the benefit of anticoagulation based on device-detected AF, 13 especially shorter episodes, given the guidelines that for HCM advocate munificent treatment, we justified dabigatran in this patient who already had suffered from a stroke.…”

Section: Atrial Fibrillation and Risk Of Strokementioning

confidence: 99%

Apical hypertrophic cardiomyopathy with preexcitation presenting as a myocardial infarction and ischemic stroke with a history of recurrent syncope: A case report

Al-Saadi

Mattsson

Kader

et al. 2019

Clinical Case Reports

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Key Clinical Message Contrast‐enhanced echocardiography or cardiac magnetic resonance imaging is of value in the diagnosis of apical hypertrophic cardiomyopathy. Apical hypertrophic cardiomyopathy is rare in Caucasians, and gene negativity does not rule out the diagnosis. Risk stratification for sudden cardiac death and decisions about anticoagulation in cases with atrial fibrillation should be based on guidelines.

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Abstract: This categorization for our consensus document should not be considered as being directly similar to that used for official society guideline recommendations which apply a classification (I-III) and level of evidence (A, B, and C) to recommendations.

Cited by 194 publications

References 114 publications

Reply to letter to the editor by Gulmira Kudaibedieva and Bulent Gorenek

Reply to letter to the editor by Gulmira Kudaibedieva and Bulent Gorenek

Estimating the incidence of atrial fibrillation in single‐chamber implantable cardioverter defibrillator patients

Apical hypertrophic cardiomyopathy with preexcitation presenting as a myocardial infarction and ischemic stroke with a history of recurrent syncope: A case report

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