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

Circulation. 2019 Dec 17;140(25):e944-e963. doi: 10.1161/CIR.0000000000000740. Epub 2019 Nov 7.

Abstract

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.

Keywords: AHA Scientific Statements; ambulatory monitoring; atrial fibrillation; cardiac arrhythmia; cardiac pacing; cerebrovascular stroke; pacemaker.

Publication types

  • Research Support, American Recovery and Reinvestment Act
  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • American Heart Association*
  • Atrial Fibrillation / diagnosis*
  • Atrial Fibrillation / physiopathology
  • Atrial Fibrillation / therapy
  • Defibrillators, Implantable / standards*
  • Defibrillators, Implantable / trends
  • Health Knowledge, Attitudes, Practice*
  • Humans
  • Pacemaker, Artificial / standards*
  • Pacemaker, Artificial / trends
  • Risk Factors
  • United States / epidemiology
  • Wearable Electronic Devices / standards*
  • Wearable Electronic Devices / trends