The DOI matches its Crossref record; 22 of the 23 references it cites were found in a registry or an index.
Asymptomatic atrial fibrillation: Demographic features and prognostic information from the Atrial Fibrillation Follow-up Investigation of Rhythm Management (AFFIRM) study
Abstract
Background Atrial fibrillation (AF) may occur without symptoms. Little is known about demographic features and prognostic information in patients with asymptomatic AF.Methods In the AFFIRM study, 4060 patients were randomized to either rhythm or rate control. At baseline, patients were identified as asymptomatic if they answered "no" to a 15-item questionnaire related to cardiac symptoms during AF in the 6 months before study entry.Results There were 481 (12%) asymptomatic patients at baseline. Compared with symptomatic patients, asymptomatic patients were more often men and had a lower incidence of coronary artery disease and congestive heart failure, but had more cerebrovascular events. Asymptomatic patients had a longer duration of AF, a lower maximum heart rate, and better left ventricular function. They received fewer cardiac medications and fewer therapies to maintain sinus rhythm. At 5 years, there was a trend for better survival in asymptomatic patients (81% vs 77%, P = .058), and they were more likely to be free from disabling stroke or anoxic encephalopathy, major bleeding, and cardiac arrest (79% vs 67%, P = .024). However, mortality and major events were similar after correction for baseline differences.Conclusions Patients with asymptomatic AF have less serious heart disease but more cerebrovascular disease. Asymptomatic patients receive different therapies than symptomatic patients. However, the absence of symptoms and the differences in treatment does not confer a more favorable prognosis when differences in baseline clinical parameters are considered. Anticoagulation should be considered in these patients.
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“Thus, in such patients, relevant arrhythmias might not be adequately diagnosed and managed.15”
From Management of patients with palpitations: a position paper from the European Heart Rhythm Association (2011) · cites this paper as [15]
In the citing paper
“It is important to underline the fact that, although cardiac rhythm disorders generally give rise to palpitations (or other related symptoms, such as fatigue, dyspnoea, dizziness, syncope, and angina), in some subjects, for reasons not entirely known but probably linked to some clinical characteristics (long-standing arrhythmias with relatively low maximum ventricular rate, male sex, absence of”
From Management of patients with palpitations: a position paper from the European Heart Rhythm Association (2011) · cites this paper as [15]
In the citing paper
“On the one hand, depending on the clinical characteristics of the patient, palpitations due to arrhythmias, in particular of ventricular origin, but also atrial fibrillation, are associated with different prognostic implications.15 -17”
From Management of patients with palpitations: a position paper from the European Heart Rhythm Association (2011) · cites this paper as [15]
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Stroke in paroxysmal atrial fibrillation: report from the Stockholm Cohort of Atrial Fibrillation
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“Asymptomatic relapses of AF in patients with symptomatic PxAF may be more than 10 times as frequent as the symptomatic episodes.(24,25) Furthermore, it may be that the period directly after spontaneous cessation of AF is a vulnerable period for embolization.”
BackgroundHughes, M., Lip, G. Y. H., & on behalf of the Guideline Development Group for the NICE national clinical guideline for management of atrial fibrillation in primary and secondary care (2008) · Thrombosis and Haemostasis · doi:10.1160/th07-08-0508 · Cited by 371
Boriani, G., Laroche, C., Diemberger, I., Fantecchi, E., Popescu, M. I., Rasmussen, L. H., Sinagra, G., Petrescu, L., Tavazzi, L., Maggioni, A. P., et al. (2014) · The American Journal of Medicine · doi:10.1016/j.amjmed.2014.11.026 · Cited by 344
“In the Atrial Fibrillation Follow-up Investigation of Rhythm Management (AFFIRM) trial (27), 12% of”
BackgroundClinical neurocardiology defining the value of neuroscience-based cardiovascular therapeutics
Shivkumar, K., Ajijola, O. A., Anand, I., Armour, J. A., Chen, P., Esler, M., De Ferrari, G. M., Fishbein, M. C., Goldberger, J. J., Harper, R. M., et al. (2016) · The Journal of Physiology · doi:10.1113/jp271870 · Cited by 308
“It is well known that some patients with arrhythmias, such as atrial fibrillation (AF), frequently mistake normal heart rhythms for recurrence of AF, or fail to correctly detect the presence of AF (Flaker et al. 2005; Hindricks et al. 2005).”
BackgroundAtrial fibrillation: the current epidemic.
Morillo, C. A., Banerjee, A., Perel, P., Wood, D. A., & Jouven, X. (2017) · Europe PMC (PubMed Central) · doi:10.11909/j.issn.1671-5411.2017.03.011 · Cited by 317
Comparison of continuous versus intermittent monitoring of atrial arrhythmias
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“In a substudy of AFFIRM, (Atrial Fibrillation Follow-up Investigation of Rhythm Management) the presence or absence of symptoms associated with AF were not associated with differences in the risk of stroke or death, taking into account differences in baseline clinical parameters.(26) The negative prognostic implicatio…”
BackgroundAtrial fibrillation and stroke prevention
Lip, G. Y. H., & Lim, H. S. (2007) · The Lancet Neurology · doi:10.1016/s1474-4422(07)70264-8 · Cited by 245
Freeman, J. V., Simon, D. N., Go, A. S., Spertus, J., Fonarow, G. C., Gersh, B. J., Hylek, E. M., Kowey, P. R., Mahaffey, K. W., Thomas, L. E., et al. (2015) · Circulation Cardiovascular Quality and Outcomes · doi:10.1161/circoutcomes.114.001303 · Cited by 246
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Management of atrial fibrillation
Lip, G. Y., & Tse, H.-F. (2007) · The Lancet · doi:10.1016/s0140-6736(07)61300-2 · Cited by 229
Ko, D., Chung, M. K., Evans, P. T., Benjamin, E. J., & Helm, R. H. (2024) · JAMA · doi:10.1001/jama.2024.22451 · Cited by 232
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“This is different from the asymptomatic patients enrolled into AFFIRM and RACE who tended to be younger and had less comorbidities than symptomatic patients in those trials.(23,24) The clinical characteristics of the asymptomatic AF population in EAST-AFNET 4 replicate features of asymptomatic patients in contemporary…”
Siontis, K. C., Gersh, B. J., Killian, J. M., Noseworthy, P. A., McCabe, P. J., Weston, S. A., Roger, V. L., & Chamberlain, A. M. (2016) · Heart Rhythm · doi:10.1016/j.hrthm.2016.03.003 · Cited by 191
Atrial fibrillation following cardiac surgery: clinical features and preventative strategies
Kairevičiūtė, D., Aidietis, A., & Lip, G. Y. H. (2008) · European Heart Journal · doi:10.1093/eurheartj/ehn609 · Cited by 172
“Various studies (Table 4) have reported that postoperative AF is associated with increased early and late mortality after cardiac surgery, 1,5,18,19,28,29 stroke, 1,18,19,30,31 and prolonged asymptomatic AF episodes 12 times more frequent compared with symptomatic AF Schuchert et al. 12 72 h Holter ECG monitoring was…”
MethodSanders, P., Pürerfellner, H., Pokushalov, E., Sarkar, S., Di Bacco, M., Maus, B., & Dekker, L. R. C. (2016) · Heart Rhythm · doi:10.1016/j.hrthm.2016.03.005 · Cited by 162
“Because medical management of AF patients is currently primarily based on symptoms, there is concern that asymptomatic, undetected events of AF could expose patients to increased risk of ischemic stroke and thromboembolic events.(10) External cardiac monitors, such as Holter monitors and mobile cardiac telemetry, are…”
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Raviele, A., Giada, F., Bergfeldt, L., Blanc, J. J., Blomstrom-Lundqvist, C., Mont, L., Morgan, J. M., Raatikainen, M. J. P., Steinbeck, G., Viskin, S., et al. (2011) · Europace · doi:10.1093/europace/eur130 · Cited by 149
“15 Thus, in such patients, relevant arrhythmias might not be adequately diagnosed and managed.(15)”
BackgroundUsefulness of Continuous Electrocardiographic Monitoring for Atrial Fibrillation
Camm, A. J., CORBUCCI, G., & Padeletti, L. (2012) · The American Journal of Cardiology · doi:10.1016/j.amjcard.2012.03.021 · Cited by 141
Screening strategies for atrial fibrillation: a systematic review and cost-effectiveness analysis
Welton, N. J., McAleenan, A., Thom, H. H. Z., Davies, P. A., Hollingworth, W., Higgins, J. P. T., Okoli, G. N., Sterne, J. A. C., Feder, G. S., Eaton, D., et al. (2017) · Health Technology Assessment · doi:10.3310/hta21290 · Cited by 142
“Flaker et al.(35) found that stroke risk was higher in symptomatic patients than asymptomatic patients, but that this difference was explained by baseline characteristics.”
BackgroundMethodResultInfluentialAdverse prognosis of incidentally detected ambulatory atrial fibrillation
Martínez, C., Katholing, A., & Freedman, S. B. (2014) · Thrombosis and Haemostasis · doi:10.1160/th4-04-0383 · Cited by 130
“Sub-clinical rapid atrial tachyarrhythmia documented by implanted pacemakers is associated with a significant increase in stroke (11, 16), but patients with implanted devices are not representative of the population with IA-AF (13, 17).”
Antithrombotic treatment in atrial fibrillation
Lip, G. Y. H., & Boos, C. J. (2005) · Postgraduate Medical Journal · doi:10.1136/hrt.2005.066944 · Cited by 124
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Gillis, A. M., Verma, A., Talajic, M. R., Nattel, S., & Dorian, P. (2011) · Canadian Journal of Cardiology · doi:10.1016/j.cjca.2010.11.001 · Cited by 122
“Many patients may have ongoing episodes of asymptomatic AF despite elimination of symptomatic episodes.(69) In the AFFIRM (Atrial Fibrillation Follow-up Investigation of Rhythm Management) trial, the risk of stroke was the same in both groups for most of the trial, but in the fifth year, a nonsignificant trend toward…”
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“Multivariable logistic regression analysis was performed to predict the relation between patient characteristics and a new screen-detected diagnosis of AF.”
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Quality of Life in Atrial Fibrillation: Measurement Tools and Impact of Interventions
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Potpara, T., Polovina, M. M., Marinković, J., & Lip, G. Y. H. (2013) · International Journal of Cardiology · doi:10.1016/j.ijcard.2013.07.234 · Cited by 110
“Patients with asymptomatic AF have been reported to have less cardiac comorbidities [4,12], but the risk of strokewas similar comparedwith symptomatic AF in a randomized clinical trial [4].”
BackgroundResultInfluentialAtrial cardiopathy: a mechanism of cryptogenic stroke
Yaghi, S. R., Kamel, H., & Elkind, M. S. V. (2017) · Expert Review of Cardiovascular Therapy · doi:10.1080/14779072.2017.1355238 · Cited by 109
“It is also important to determine if the stroke risk attributed to these biomarkers is independent of coexisting AF.”
BackgroundInfluentialAtrial high-rate episodes and stroke prevention
Camm, A. J., SIMANTIRAKIS, E. N., Goette, A., Lip, G. Y. H., Vardas, P. E., Calvert, M., CHLOUVERAKIS, G. I., Diener, H., & Kirchhof, P. F. (2016) · EP Europace · doi:10.1093/europace/euw279 · Cited by 104
“These patients had a lower incidence of serious heart disease but more cerebrovascular events (CVEs).(26) Among patients presenting with an acute stroke, 5% have previously undetected AF on admission.”
BackgroundManagement of atrial fibrillation: Figure 1
Lip, G. Y. H., & Tello-Montoliu, A. (2006) · Heart · doi:10.1136/hrt.2005.071555 · Cited by 99
Turakhia, M. P., Ullal, A. J., Hoang, D. D., Than, C. T., Miller, J. D., Friday, K. J., Perez, M. V., Freeman, J. V., Wang, P. J., & Heidenreich, P. A. (2015) · Clinical Cardiology · doi:10.1002/clc.22387 · Cited by 98
Jacobs, M. S., Kaasenbrood, F., Postma, M. J., van Hulst, M., & Tieleman, R. G. (2016) · EP Europace · doi:10.1093/europace/euw285 · Cited by 97
“8).(7,8) The absence of symptoms does not necessarily imply a more favourable prognosis.”
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Arya, A., Piorkowski, C., Sommer, P., Kottkamp, H., & Hindricks, G. (2007) · Pacing and Clinical Electrophysiology · doi:10.1111/j.1540-8159.2007.00693.x · Cited by 90
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World Heart Federation Roadmap on Atrial Fibrillation – A 2020 Update
Freedman, B., Hindricks, G., Banerjee, A., Baranchuk, A. M., Ching, C. K., Du, X., Fitzsimons, D., Healey, J. S., Ikeda, T., Lobban, T., et al. (2021) · Global Heart · doi:10.5334/gh.1023 · Cited by 95
Stroke and Embolic Events in Hypertrophic Cardiomyopathy
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“In addition, the onset and time course of AF (before or after embolic events) was unclear in the above reports, and patients who had developed AF after their first event may also have been included in the group with AF.”
BackgroundInfluentialBoriani, G., & Pettorelli, D. (2016) · Vascular Pharmacology · doi:10.1016/j.vph.2016.03.006 · Cited by 85
Kaleschke, G., Hoffmann, B., Drewitz, I., Steinbeck, G., Naebauer, M., Goette, A., Breithardt, G., & Kirchhof, P. (2009) · Europace · doi:10.1093/europace/eup262 · Cited by 81
Sgreccia, D., Manicardi, M., Malavasi, V. L., Vitolo, M., Valenti, A. C., Proietti, M., Lip, G. Y. H., & Boriani, G. (2021) · Journal of Clinical Medicine · doi:10.3390/jcm10173979 · Cited by 84
“Five studies [19,21,23,30,31] reported data on non-haemorrhagic stroke; the overall pooled estimate showed no significant differences between asymptomatic and symptomatic AF patients (OR 1.”
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The Blinding Period Following Ablation Therapy for Atrial Fibrillation
Gottlieb, L. A., Dekker, L., & Coronel, R. (2021) · JACC. Clinical electrophysiology · doi:10.1016/j.jacep.2021.01.011 · Cited by 80
Lamirault, G., Gaborit, N., Meur, N. L., Chevalier, C., Lande, G., Demolombe, S., Escande, D., Nattel, S., Leger, J. J., & Steenman, M. (2005) · Journal of Molecular and Cellular Cardiology · doi:10.1016/j.yjmcc.2005.09.004 · Cited by 75
Catheter ablation of atrial fibrillation in patients with therapeutic oral anticoagulation treatment
Hakalahti, A., Uusimaa, P., Ylitalo, K. V., & Raatikainen, M. J. P. (2011) · EP Europace · doi:10.1093/europace/eur038 · Cited by 74
Hendrikx, T., Rosenqvist, M., Wester, P. O., Sandström, H., & Hörnsten, R. (2014) · BMC Cardiovascular Disorders · doi:10.1186/1471-2261-14-41 · Cited by 73
“As stroke risk is the same for symptomatic and non-symptomatic AF patients, [16] this method”
BackgroundAsymptomatic persistent atrial fibrillation and outcome: Results of the RACE study
Rienstra, M., Vermond, R. A., Crijns, H. J. G. M., Tijssen, J. G. P., & Gelder, I. C. V. (2014) · Heart Rhythm · doi:10.1016/j.hrthm.2014.03.016 · Cited by 73
“Left ventricular dimensions were smaller and fractional shortening was higher in patients with asymptomatic AF.”
BackgroundResultInfluentialPatient-reported triggers of paroxysmal atrial fibrillation
Groh, C. A., Modrow, M. F., Getabecha, S., Taffe, V., Nah, G., Sigona, K., McCall, D., Hills, M. T., Sciarappa, K., Pletcher, M. J., et al. (2019) · Heart Rhythm · doi:10.1016/j.hrthm.2019.01.027 · Cited by 73
Stratifying Stroke Risk in Atrial Fibrillation
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Ethnic Differences in Atrial Fibrillation Identified Using Implanted Cardiac Devices
LAU, C., Gbadebo, T. D., Connolly, S. J., Gelder, I. C. V., Capucci, A., Gold, M. R., Israel, C. W., Morillo, C. A., Siu, C., Abe, H., et al. (2013) · Journal of Cardiovascular Electrophysiology · doi:10.1111/jce.12066 · Cited by 68
Gender-Specific Relationship Between Serum Uric Acid Level and Atrial Fibrillation Prevalence
Suzuki, S. S., Sagara, K., Otsuka, T., Matsuno, S., Funada, R., Uejima, T., Oikawa, Y., Koike, A., Nagashima, K., Kirigaya, H., et al. (2011) · Circulation Journal · doi:10.1253/circj.cj-11-1111 · Cited by 65
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Dixit, S., Stein, P. K., Dewland, T. A., Dukes, J. W., Vittinghoff, E., Heckbert, S. R., & Marcus, G. M. (2016) · Journal of the American Heart Association · doi:10.1161/jaha.115.002503 · Cited by 63
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“than 140,000 individuals, males predominated over females in all age strata,(19) and in the Atrial Fibrillation Follow-Up Investigation of Rhythm Management (AFFIRM) study, male sex accounted for 77% of asymptomatic patients.(6) AFFIRM also found that asymptomatic patients were more likely to have had prior stroke and…”
BackgroundResultInfluentialAF burden is important - fact or fiction?
Boriani, G., Diemberger, I., Ziacchi, M., Valzania, C., Gardini, B., Cimaglia, P., Martignani, C., & Biffi, M. (2014) · International Journal of Clinical Practice · doi:10.1111/ijcp.12326 · Cited by 59
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Clinical Predictors of Risk for Atrial Fibrillation
Brunner, K. J., Bunch, T. J., Mullin, C. M., May, H. T., Bair, T. L., Elliot, D. W., Anderson, J. L., & Mahapatra, S. (2014) · Mayo Clinic Proceedings · doi:10.1016/j.mayocp.2014.08.016 · Cited by 59
Sulzgruber, P., Waßmann, S., Semb, A. G., Doehner, W., Widimský, P., Gremmel, T., Kaski, J. C., Savarese, G., Rosano, G. M. C., Borghi, C., et al. (2019) · European Heart Journal - Cardiovascular Pharmacotherapy · doi:10.1093/ehjcvp/pvz016 · Cited by 58
Podd, S. J., Sugihara, C., FURNISS, S. S., & Sulke, N. (2015) · EP Europace · doi:10.1093/europace/euv367 · Cited by 58
“The presence of asymptomatic AF still carries significant morbidity.(7) Recent assessments trying to evaluate the relationship between AF burden and the risk to patients suggest that as little as 5 min of arrhythmia may convey an increased stroke risk.”
BackgroundWallenhorst, C., Martínez, C., & Freedman, B. (2021) · Thrombosis and Haemostasis · doi:10.1055/a-1541-3885 · Cited by 53
Major clinical outcomes in symptomatic vs. asymptomatic atrial fibrillation: a meta-analysis
Karakasis, P., Pamporis, K., Siontis, K. C., Theofilis, P., Samaras, A., Patoulias, D., Stachteas, P., Karagiannidis, E., Stavropoulos, G., Tzikas, A., et al. (2024) · European Heart Journal · doi:10.1093/eurheartj/ehae694 · Cited by 52
Luong, C. L., Thompson, D. J. S., Bennett, M. T., Gin, K. G., Jue, J., Barnes, M. E., Colley, P., & Tsang, T. S. M. (2014) · Canadian Journal of Cardiology · doi:10.1016/j.cjca.2014.10.009 · Cited by 52
The World Heart Federation Roadmap for Nonvalvular Atrial Fibrillation
Murphy, A., Banerjee, A., BREITHARDT, G. E., Camm, A. J., Commerford, P., Freedman, B., González-Hermosillo, J. A., Halperin, J. L., Lau, C., Perel, P., et al. (2017) · Global Heart · doi:10.1016/j.gheart.2017.01.015 · Cited by 53
“The absence of symptoms among patients presenting with AF does not suggest lower risk of stroke and these asymptomatic patients should also undergo thorough clinical assessment [11,41,42].”
BackgroundDetection of atrial fibrillation using an earlobe photoplethysmographic sensor
Conroy, T. B., Guzman, J. H., HALL, B. W., Tsouri, G. R., & Couderc, J. (2017) · Physiological Measurement · doi:10.1088/1361-6579/aa8830 · Cited by 48
“[5] Most studies estimate the rate of subclinical AF to be between 10%-40% of all AF patients.”
BackgroundAtrial Cardiopathy and Stroke Prevention
Elkind, M. S. V. (2018) · Current Cardiology Reports · doi:10.1007/s11886-018-1053-0 · Cited by 50
Brunetti, N. D., Gennaro, L. D., Pellegrino, P. L., Dellegrottaglie, G., Antonelli, G., & Biase, M. D. (2011) · European Journal of Preventive Cardiology · doi:10.1177/1741826711406060 · Cited by 47
“At 5 years, there was a trend for better survival in asymptomatic patients, and they were more likely to be free from disabling stroke or anoxic encephalopathy, major bleeding, and cardiac arrest.(22) However, mortality and major events were similar after correction for baseline differences.”
BackgroundBakhai, A., Darius, H., Caterina, R. D., Smart, A., Heuzey, J. L., SCHILLING, R. J., Zamorano, J. L., Shah, M., Bramlage, P., & Kirchhof, P. F. (2016) · European Heart Journal - Quality of Care and Clinical Outcomes · doi:10.1093/ehjqcco/qcw031 · Cited by 47
“for the cohort of AF patients in the AFFIRM study (33 and 41% female asymptomatic and symptomatic patients, respectively), while other studies have also described a lower percentage of female asymptomatic patients.(17,18,22) This may have implications for proposed systematic screening programmes, which have so far dem…”
BackgroundResultAblation to Reduce Atrial Fibrillation Burden and Improve Outcomes
Schwennesen, H. T., Andrade, J. G., Wood, K., & Piccini, J. P. (2023) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2023.06.029 · Cited by 53
Dobreanu, D., Svendsen, J. H., Lewalter, T., Hernández‐Madrid, A., Lip, G. Y. H., & Blomström‐Lundqvist, C. (2013) · EP Europace · doi:10.1093/europace/eut227 · Cited by 45
Esato, M., Chun, Y., An, Y., Ogawa, H., Wada, H., Hasegawa, K., Tsuji, H., Abe, M., Lip, G. Y. H., & Akao, M. (2017) · CHEST Journal · doi:10.1016/j.chest.2017.08.004 · Cited by 45
“org inconsistent with previous randomized clinical trials.(5,18) Our data also found worse clinical outcomes in asymptomatic patients compared with the clinical outcomes of symptomatic patients in the PAF group but not in the SAF group.”
ResultSymptom Burden of Atrial Fibrillation and Its Relation to Interventions and Outcome in Europe
Schnabel, R. B., Pecen, L., Rzayeva, N., Lucerna, M., Purmah, Y., Ojeda, F., Caterina, R. D., & Kirchhof, P. F. (2018) · Journal of the American Heart Association · doi:10.1161/jaha.117.007559 · Cited by 45
Pecha, S., Schäfer, T., Yıldırım, Y., Ahmadzade, T., Willems, S., Reichenspurner, H. C., & Wagner, F. (2013) · Journal of Thoracic and Cardiovascular Surgery · doi:10.1016/j.jtcvs.2013.03.012 · Cited by 44
Thijs, V. (2017) · Stroke · doi:10.1161/strokeaha.117.017083 · Cited by 43
Leclercq, C., Padeletti, L., Cihak, R., Ritter, P., Milašinović, G., Gras, D., Paul, V. E., Gelder, I. C. V., Stellbrink, C., Rieger, G., et al. (2009) · EP Europace · doi:10.1093/europace/eup318 · Cited by 42
Lip, G. Y. H., Skjøth, F., Nielsen, P. B., & Larsen, T. B. (2019) · The American Journal of Cardiology · doi:10.1016/j.amjcard.2019.09.034 · Cited by 42
Antithrombotic treatment in atrial fibrillation
Kalra, L., & Lip, G. Y. H. (2006) · Heart · doi:10.1136/hrt.2006.099911 · Cited by 42
Stroke Prevention for Patients with Atrial Fibrillation: Beyond the Guidelines
McIntyre, W. F., & Healey, J. S. (2017) · Journal of Atrial Fibrillation · doi:10.4022/jafib.1475 · Cited by 40
Atrial Fibrillation and Antithrombotic Therapy in a 75-Year-Old Population
Tveit, A., Abdelnoor, M., Enger, S., & Smith, P. (2007) · Cardiology · doi:10.1159/000107789 · Cited by 39
“These patients have the same, or maybe even increased, risk of stroke [”
BackgroundAre atrial high rate episodes (AHREs) a precursor to atrial fibrillation?
Khan, A. A., Boriani, G., & Lip, G. Y. H. (2019) · Clinical Research in Cardiology · doi:10.1007/s00392-019-01545-4 · Cited by 39
Vermond, R. A., Crijns, H. J. G. M., Tijssen, J. G. P., ALINGS, A. M. W., van den Berg, M. P., Hillege, H. L., van Veldhuisen, D. J., Gelder, I. C. V., Rienstra, M., & for the RACE II investigators (2014) · EP Europace · doi:10.1093/europace/euu151 · Cited by 39
“In previous studies symptom burden of paroxysmal and persistent AF patients was driven by more severe underlying heart disease,(2,12) but were not associated with future cardiovascular events.”
BackgroundMethodResultInfluentialProgression to the Persistent Form in Asymptomatic Paroxysmal Atrial Fibrillation
Senoo, K., Suzuki, S. S., Otsuka, T., Sagara, K., Matsuno, S., Kano, H., Uejima, T., Oikawa, Y., Yajima, J., Nagashima, K., et al. (2014) · Circulation Journal · doi:10.1253/circj.cj-13-1272 · Cited by 38
Symptomatic atrial fibrillation and risk of cardiovascular events: data from the Euro Heart Survey
Guerra, F., Brambatti, M., Nieuwlaat, R., Marcucci, M., Dudink, E. A. M. P., Crijns, H. J. G. M., Matassini, M. V., & Capucci, A. (2017) · EP Europace · doi:10.1093/europace/eux205 · Cited by 38
Garimella, R. S., Chung, E. H., Mounsey, J. P., Schwartz, J., Pursell, I. W., & Gehi, A. K. (2015) · Heart Rhythm · doi:10.1016/j.hrthm.2015.01.012 · Cited by 37
Disertori, M., Lombardi, F., Barlera, S., Maggioni, A. P., Favero, C., Franzosi, M. G., Lucci, D., Staszewsky, L. I., Fabbri, G., Quintarelli, S., et al. (2011) · American Heart Journal · doi:10.1016/j.ahj.2011.05.008 · Cited by 37
“Several reports have indicated that within the same patient, symptomatic and asymptomatic AF episodes may be present.(1-12) Moreover, the percentage of asymptomatic episodes is strictly correlated with the modality and duration of electrocardiographic monitoring.”
BackgroundAngelis, M. V. D., Stefano, V. D., Franciotti, R., Furia, N., Girolamo, E. D., ONOFRJ, M. C., & Faustino, M. (2020) · Scientific Reports · doi:10.1038/s41598-020-60180-6 · Cited by 37
Atrial fibrillation, arrhythmia burden and thrombogenesis
Khoo, C. W., Krishnamoorthy, S., Lim, H. S., & Lip, G. Y. H. (2011) · International Journal of Cardiology · doi:10.1016/j.ijcard.2011.06.088 · Cited by 37
“Indeed, asymptomatic AF has been proposed as a reason for the higher incidence of stroke in the rhythm control arm of recent trials comparing a rate control versus rhythm control management strategy [65].”
BackgroundCompressed Deep Learning to Classify Arrhythmia in an Embedded Wearable Device
Lee, K.-S., Park, H.-J., Kim, J. E., Kim, H. J., Chon, S., Kim, S., Jang, J., Kim, J.-K., Jang, S., Gil, Y., et al. (2022) · Sensors · doi:10.3390/s22051776 · Cited by 36
A prospective 5-year follow-up after population-based systematic screening for atrial fibrillation
Engdahl, J., Holmén, A., Rosenqvist, M., & Strömberg, U. (2018) · EP Europace · doi:10.1093/europace/euy045 · Cited by 34
Hendrikx, T., Hörnsten, R., Rosenqvist, M., & Sandström, H. (2013) · BMC Cardiovascular Disorders · doi:10.1186/1471-2261-13-41 · Cited by 34
“Since AF is often asymptomatic it may remain undiagnosed for a long time and many of these patients will not receive OAC before suffering a stroke [11].”
BackgroundPrevention of stroke in patients with atrial fibrillation: current strategies and future directions
Hohnloser, S. H., Duray, G. Z., Baber, U., & Halperin, J. L. (2008) · European Heart Journal Supplements · doi:10.1093/eurheartj/sun029 · Cited by 34
“Indeed, the risk of thrombo-embolism is independent of the presence or absence of symptoms such as palpitations.(41) To clarify this issue, two prospective trials involving patients with implanted cardiac devices who are not receiving anticoagulant medication are examining the association between asymptomatic atrial h…”
Background
Metadata
- Authors
- Flaker, G. C., Belew, K., Beckman, K., Vidaillet, H., Kron, J., Safford, R., Mickel, M., & Barrell, P.
- Affiliations
- University of Missouri (US)
- University of Oklahoma Health Sciences Center (US)
- Oregon Health & Science University (US)
- Mayo Clinic in Florida (US)
- Corresponding author
- Flaker, Greg C.
- ORCID
- Safford, Robert
- Venue
- American Heart Journal
- Publisher
- Elsevier BV
- Published
- 2005-04
- Volume
- 149
- Issue
- 4
- Pages
- 657-663
- ISSN
- 0002-8703 (ISSN-L)
- OpenAlex
- W1977819036
- Cited by
- 341
- References
- 23
- Citations by year
- 2026: 4 · 2025: 9 · 2024: 25 · 2023: 9 · 2022: 23 · 2021: 21 · 2020: 18 · 2019: 18 · 2018: 17 · 2017: 24 · 2016: 26 · 2015: 21 · 2014: 26 · 2013: 15 · 2012: 15
- FWCI
- 7.30
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Heart Journal (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (n01hc055139-000)
- National Heart, Lung, and Blood Institute (N01-HC-55139)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Atrial Fibrillation Management and Outcomes
- Health Sciences › Medicine › Clinical Neurology › Acute Ischemic Stroke Management
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac pacing and defibrillation studies
- Keywords
- asymptomatic atrial fibrillation, atrial fibrillation, prognosis, demographic factors, rhythm control, rate control, stroke, major bleeding, cardiac arrest, anticoagulation, left ventricular function, atrial fibrillation duration, AFFIRM trial
- MeSH terms
- Aged, Anti-Arrhythmia Agents, Anticoagulants, Atrial Fibrillation, Cause of Death, Cerebrovascular Disorders, Coronary Disease, Electric Countershock, Female, Follow-Up Studies, Heart Arrest, Heart Failure, Hemorrhage, Humans, Male, Middle Aged, Prognosis, Quality of Life, Socioeconomic Factors, Comorbidity, Incidence, Survival Analysis, Treatment Outcome, Ventricular Dysfunction, Left
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