Meynet, Ilaria;
Karvonen, Jarkko;
Boriani, Giuseppe;
Penela, Diego;
Mazurek, Michal;
Mugnai, Giacomo;
Providencia, Rui;
... Perrotta, Laura; + view all
(2025)
Management of device-detected subclinical atrial fibrillation: A european heart rhythm association survey.
EP Europace
, Article euaf284. 10.1093/europace/euaf284.
(In press).
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Abstract
Background and aims: Device-detected subclinical atrial fibrillation (DDAF) is increasingly documented either with implantable cardiac electronic devices (CIED) or with consumer-based mobile or wearable monitors. The management of this condition is still matter of debate. // Methods: This is a physician-based survey with 24 multiple-choice questions. // Results: A total of 222 physicians from 46 countries responded the survey. DDAF is frequent, occurring in >10% of CIEDs follow-up for 37% of respondents. Oral anticoagulation is prescribed according to CHA2DS2-VA and AF duration; 34% of the respondents initiate anticoagulation with AF > 24 hours, 26% with AF > 6 hours and 15% with AF > 5-6 minutes. Respondents from Non-European countries and Mediterranean Europe are more likely to prescribe diagnostic exams and therapy than respondents from North Europe. Systematic long-term AF screening with implantable loop recorder (ILR) after cryptogenic stroke ranges from 43±27% of ILR implanted for that purpose in Mediterranean countries to 10±20% in North Europe. The majority of responders recommends the use of consumer-based devices to screen for AF mainly in specific situations (undiagnosed palpitations, ischemic stroke or AF burden monitoring) and not routinely, just according to CHA2DS2-VA or age. // Conclusion: AF screening is not routinely performed, either in primary or secondary prevention of stroke. Device-detected AF is not uncommon and generally managed based on thromboembolic risk and duration of episodes; the cut-offs of AF duration, global burden and number of episodes are yet to be determined in terms of role and clinical value. Clinicians’ approaches to subclinical AF remain heterogeneous.
| Type: | Article |
|---|---|
| Title: | Management of device-detected subclinical atrial fibrillation: A european heart rhythm association survey |
| Location: | England |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1093/europace/euaf284 |
| Publisher version: | https://doi.org/10.1093/europace/euaf284 |
| Language: | English |
| Additional information: | Copyright © The Author(s) 2025. Published by Oxford University Press on behalf of the European Society of Cardiology. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com. |
| Keywords: | Atrial fibrillation, oral anticoagulation, implantable devices, consumed-based devices, screening |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Health Informatics |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10217374 |
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