Atrial fibrillation burden: an update-the need for a CHA2DS2-VASc-AFBurden score

Kathryn D Tiver; Jing Quah; Anandaroop Lahiri; Anand N Ganesan; Andrew D McGavigan

doi:10.1093/europace/euaa287

Atrial fibrillation burden: an update-the need for a CHA2DS2-VASc-AFBurden score

Europace. 2021 May 21;23(5):665-673. doi: 10.1093/europace/euaa287.

Authors

Kathryn D Tiver¹, Jing Quah^{1

2}, Anandaroop Lahiri¹, Anand N Ganesan^{1

2}, Andrew D McGavigan^{1

2}

Affiliations

¹ Department of Cardiovascular Medicine, Flinders Medical Centre, Bedford Park, South Australia 5042, Australia.
² College of Medicine and Public Health, Flinders University of South Australia, Bedford Park, South Australia 5042, Australia.

PMID: 33351904
DOI: 10.1093/europace/euaa287

Abstract

Atrial fibrillation (AF) is an established independent risk factor for stroke. Current guidelines regard AF as binary; either present or absent, with the decision for anti-coagulation driven by clinical variables alone. However, there are increasing data to support a biological gradient of AF burden and stroke risk, both in clinical and non-clinical AF phenotypes. As such, this raises the concept of combining AF burden assessment with a clinical risk score to refine and individualize the assessment of stroke risk in AF-the CHA2DS2VASc-AFBurden score. We review the published data supporting a biological gradient to try and construct a putative schema of risk attributable to AF burden.

Keywords: Atrial fibrillation; Atrial high rate episodes; Burden; Duration; Stroke; Systemic embolism.

Publication types

Review

MeSH terms

Atrial Fibrillation* / diagnosis
Atrial Fibrillation* / epidemiology
Humans
Risk Assessment
Risk Factors
Stroke* / diagnosis
Stroke* / epidemiology
Stroke* / etiology