Author + information
- Received June 29, 2014
- Revision received October 14, 2014
- Accepted October 14, 2014
- Published online January 27, 2015.
- Carol Chen-Scarabelli, PhD∗,
- Tiziano M. Scarabelli, MD, PhD†∗ (, )
- Kenneth A. Ellenbogen, MD‡ and
- Jonathan L. Halperin, MD†
- ∗Veterans Affairs Ann Arbor Health Care System, University of Michigan, Ann Arbor, Michigan
- †Zena and Michael A. Wiener Cardiovascular Institute, Mount Sinai Medical Center, New York, New York
- ‡Department of Medicine, Virginia Commonwealth University School of Medicine, Richmond, Virginia
- ↵∗Research requests and correspondence:
Dr. Tiziano M. Scarabelli, Zena and Michael A. Wiener Cardiovascular Institute, Mount Sinai Medical Center, One Gustave L. Levy Place, Box 1030, New York, New York 10029-6574.
Atrial fibrillation (AF) is the most common clinically significant arrhythmia and conveys an increased risk of stroke, regardless of whether it is symptomatic. Despite multiple studies supporting an association between subclinical atrial tachyarrhythmias (ATs) detected by cardiac implantable electronic devices and increased risk of thromboembolic events, clinical intervention for device-detected AT remains sluggish, with some clinicians delaying treatment and instead opting for continued surveillance for additional or longer episodes. However, the 2014 updated clinical practice guidelines on AF recommend use of the CHA2DS2-VASc stroke risk score for nonvalvular AF, with oral anticoagulation recommended for scores ≥2, regardless of whether AF is paroxysmal, persistent, or permanent. This paper reviews the epidemiology of AF and mechanisms of stroke in AF, and discusses device-detected AF and its clinical implications.
- atrial tachyarrhythmias
- cardiac implantable electronic devices
- cerebral embolism
- implantable cardiac monitor
Dr. Ellenbogen has served as a consultant for Medtronic, Boston Scientific and St. Jude Medical, and has received research, honorarium, and fellowship support from Medtronic and Boston Scientific. Dr. Halperin has served as a consultant for Bayer Healthcare, Boehringer Ingelheim, Bristol-Myers Squibb, Daiichi Sankyo, Pfizer, Inc., Biotronik, Boston Scientific, and Medtronic. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. Drs. Ellenbogen and Halperin contributed equally to this work as senior authors. Sumeet Chugh, MD, served as Guest Editor for this paper.
- Received June 29, 2014.
- Revision received October 14, 2014.
- Accepted October 14, 2014.
- American College of Cardiology Foundation
- Mechanisms of AF
- AF and Stroke
- Mechanisms of Stroke in AF
- Device-Detected AF
- Review of Publications on Device-Detected AF
- Temporal Association Between Device-Detected AT/AF and Stroke
- Anticoagulation for AF: Effects on Stroke Prevention, Stroke Severity, and Mortality
- Current Clinical Practices in Subclinical AT/AF