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.
Overview
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In the citing paper
“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]
Citations
Cites
Folstein, M. F., Folstein, S. E., & McHugh, P. R. (1975) · Journal of Psychiatric Research · doi:10.1016/0022-3956(75)90026-6 · Cited by 88,282
(1992) · PubMed · Cited by 33,716
McHorney, C. A., Ware, J. E., Rachel Lu, J. F., & Sherbourne, C. D. (1994) · Medical Care · doi:10.1097/00005650-199401000-00004 · Cited by 4,458
A comparison of rate control and rhythm control in patients with atrial fibrillation
(2002) · New England Journal of Medicine · doi:10.1056/nejmoa021328 · Cited by 4,405
Gelder, I. C. V., Hagens, V. E., Bosker, H. A., Kingma, J. H., Otto Kamp, B., Kingma, T., Said, S. A., Darmanata, J. I., Timmermans, A. J. M., Tijssen, J. G. P., et al. (2002) · New England Journal of Medicine · doi:10.1056/nejmoa021375 · Cited by 2,355
Feinberg, W. M. (1995) · Archives of Internal Medicine · doi:10.1001/archinte.155.5.469 · Cited by 2,282
Ferrans, C. E., & Powers, M. J. (1985) · Advances in Nursing Science · doi:10.1097/00012272-198510000-00005 · Cited by 1,124
Glotzer, T. V., Hellkamp, A. S., Zimmerman, J., Sweeney, M. O., Yee, R., Marinchak, R., Cook, J., Paraschos, A., Love, J., Radoslovich, G., et al. (2003) · Circulation · doi:10.1161/01.cir.0000057981.70380.45 · Cited by 750
Page, R. L., Wilkinson, W. E., Clair, W. K., McCarthy, E. A., & Pritchett, E. L. (1994) · Circulation · doi:10.1161/01.cir.89.1.224 · Cited by 627
Characterization of Different Subsets of Atrial Fibrillation in General Practice in France
Lévy, S., Maarek, M., Coumel, P., Guize, L., Lekieffre, J., Medvedowsky, J. L., & Sebaoun, A. (1999) · Circulation · doi:10.1161/01.cir.99.23.3028 · Cited by 580
Flagged first, then by citations
1 of the 23 references couldn’t be matched to a known paper.
Research works printed but not linked: 1
- Neumann, 2002, Occurrence of silent atrial fibrillation after catheter ablation of the pulmonary veins, Circulation, 106, II
Cited by
Sorted by citations
Items 301–342 of 342
Luong, C. L., Bennett, M. T., Gin, K. G., Jue, J., Barnes, M. E., & Tsang, T. S. M. (2015)
Detection of Atrial Fibrillation Using an Earlobe Photoplethysmographic Sensor
Conroy, T. B., Guzman, J. H., HALL, B. W., Tsouri, G. R., & Couderc, J. (2017) · Computing in cardiology · doi:10.22489/cinc.2017.048-128
Overview of stroke in atrial fibrillation
Diener, H. (2012) · doi:10.2217/ebo.12.49
Polovina, M. M., Potpara, T., & Prostran, M. S. (2014) · Srce i krvni sudovi · doi:10.5937/siks1403192p
LAA Closure: Where we stand now?
Yuniadi, Y. (2014) · Indonesian Journal of Cardiology · doi:10.30701/ijc.v34i3.334
Atrial Fibrillation Episodes of Illness in a Primary Care Setting
Tarasevich, A. (2019) · Scholarship@Western (Western University)
Allan, V., Sammon, C., McDonald, L., Mehmud, F., Alikhan, R., & Ramagopalan, S. V. (2019) · Future Cardiology · doi:10.2217/fca-2019-0025
Chen, J., Lin, C. K., Lin, C., Yu, F., Li, K.-J., & Tsai, L. (2020) · IEEE Access · doi:10.1109/access.2020.3026833
“tomatic AF has been associated with similar morbidity and mortality rates as symptomatic AF [4].”
BackgroundCardiovascular Risk Factors in Atrial Fibrillation Associated with Ischaemic Heart Disease
Torres, O. Y., Pérez-Mur, J., Gutiérrez, E., Valls, J., Fornés, S., & Torres, O. Y. (2020) · Journal of Integrative Cardiology Open Access · doi:10.31487/j.jicoa.2020.06.08
Васильевна, П. О., Дурманов, С. С., Voevodin, A. A., & Базылев, В. В. (2021) · Journal of Arrhythmology · doi:10.35336/va-2020-4-5-11
“But, in 12% of patients, AF may be asymptomatic [21] and the development of heart rhythm disorders in the postoperative period may be a verification of a previously preprocedural unknown AF [3].”
BackgroundPoorthuis, M. H. F. (2021) · doi:10.33540/79
HEART RHYTHM DISORDERS: THE IMPORTANCE OF SYSTEMIC APPROACH
Snezhitskiy, V. А., & Kalatsei, L. V. (2021) · Journal of the Grodno State Medical University · doi:10.25298/2221-8785-2021-19-3-335-343
Kobalava, Z. D., & Анатольевич, Ш. А. (2021) · Russian Journal of Cardiology · doi:10.15829/1560-4071-2021-4653
Васильевна, П. О., Дурманов, С. С., Voevodin, A. A., & Базылев, В. В. (2021) · Journal of Arrhythmology · doi:10.35336/va-2021-e-39-43
New-onset Heart Failure With Atrial Fibrillation: A Distinct Type of Cardiomyopathy?
Lakkireddy, D. (2020) · Journal of Atrial Fibrillation · doi:10.4022/jafib.20200441
Detection of atrial fibrillation
Gurp, N. V.-V. (2022) · doi:10.26481/dis.20220325nv
Mihajlovic, M., Šimić, J., Marinković, M. M., Mujović, N. M., Prostran, M. S., & Potpara, T. (2022) · Galenika Medical Journal · doi:10.5937/galmed2201093m
Neue Ansätze zur Früherkennung von Vorhofflimmern
Ohlrogge, A. H., Goette, A., Schotten, U., & Schnabel, R. B. (2022) · Nervenheilkunde · doi:10.1055/a-1755-7997
Atrial Fibrillation and Stroke
Spagnolo, F., Pinto, V., & Rini, A. M. (2022) · IntechOpen eBooks · doi:10.5772/intechopen.104619 · Cited by 1
Tsai, C., Chiou, W., Huang, C., Lin, P., Lee, Y., Lin, S.-I., & Liao, F. (2022) · SSRN Electronic Journal · doi:10.2139/ssrn.4185915
Bénali, K., & Guénancia, C. (2022) · EMC - Tratado de Medicina · doi:10.1016/s1636-5410(22)46832-2
Is Continuous Monitoring for Arrhythmia Advantageous in Low-Risk Groups?
Matsubara, T. J., & Fujiu, K. (2022) · JACC Asia · doi:10.1016/j.jacasi.2022.09.004
“AF duration leading to cardiogenic stroke is considered shorter in high-risk subjects compared with low-risk subjects.(13) Some studies showed that just 6 hours of AF duration in subjects with a higher CHA2DS2-VASc score leads to risk of ischemic stroke caused by AF.”
BackgroundBénali, K., & Guénancia, C. (2022) · EMC - AKOS - Trattato di Medicina · doi:10.1016/s1634-7358(22)46915-4
Short term atrial fibrillation in different stroke entitiesPreprint
Boettger, P., Kracht, T., Schulz, N., Ott, K., Klemm, P., Lange, U., Müller‐Ladner, U., Rolf, A., Lemm, H., & Buerke, M. (2023) · medRxiv · doi:10.1101/2023.09.28.23296319
Erdoğan, A., & Genç, Ö. (2024) · Anatolian Current Medical Journal · doi:10.38053/acmj.1405564
Association between depression, quality of life, and ablation for atrial fibrillation
Kataoka, N., & Imamura, T. (2024) · Journal of Interventional Cardiac Electrophysiology · doi:10.1007/s10840-024-01739-5
“Roughly half of atrial fibrillation patients are asymptomatic [2].”
Lee, S. H., Moon, S., Cha, M., Lee, S., Kim, J. Y., Kwon, C. H., Shim, J., Park, J., Kim, K., Yang, P., et al. (2024) · Journal of Cardiovascular Electrophysiology · doi:10.1111/jce.16508
Limonova, A. S., Minenko, I. A., Sukmanova, A. A., Davtyan, K. V., Ershova, A. I., & Drapkina, O. M. (2024) · Rational Pharmacotherapy in Cardiology · doi:10.20996/1819-6446-2024-3144
Poggio, A., Sullivan, A. P., Rampa, L., Andrade, J. G., & Anselmino, M. (2025) · Medicina · doi:10.3390/medicina61071200 · Cited by 1
“Up to 4–8% of patients whose AF lasts for just 6 to 48 h are completely asymptomatic [22], raising the risk of cardioversion being performed beyond the recommended 48-h window.”
InfluentialSuzuki, S., Sugawara, E., Yamaura, G., Yokoyama, M., Joki, H., Miyaji, Y., Higashiyama, Y., Momoo, T., Doi, H., & Tanaka, F. (2025) · Journal of Clinical Neurology · doi:10.3988/jcn.2025.0103
Oshima, T., Akazawa, H., Ishida, J., Kadowaki, H., Shindo, A., Ueda, T., Amano, Y., Watanabe, K., Fujiu, K., Kage, H., et al. (2025) · Circulation Reports · doi:10.1253/circrep.cr-25-0136
“41 In the EurObservational Research Programme – Atrial Fibrillation (EORP-AF) Pilot General Registry, 39.7% of enrolled AF patients were asymptomatic (EHRA score 1).”
InfluentialStraat, K., Isaksson, E., Laska, A. C., Rooth, E., Svennberg, E., Åsberg, S., Wester, P., & Engdahl, J. (2024) · Figshare · doi:10.6084/m9.figshare.26704995
Straat, K., Isaksson, E., Laska, A. C., Rooth, E., Svennberg, E., Åsberg, S., Wester, P., & Engdahl, J. (2024) · Figshare · doi:10.6084/m9.figshare.26704992
Straat, K., Isaksson, E., Laska, A. C., Rooth, E., Svennberg, E., Åsberg, S., Wester, P., & Engdahl, J. (2024) · Figshare · doi:10.6084/m9.figshare.26705001
Straat, K., Isaksson, E., Laska, A. C., Rooth, E., Svennberg, E., Åsberg, S., Wester, P., & Engdahl, J. (2024) · Figshare · doi:10.6084/m9.figshare.26704989
Straat, K., Isaksson, E., Laska, A. C., Rooth, E., Svennberg, E., Åsberg, S., Wester, P., & Engdahl, J. (2024) · Figshare · doi:10.6084/m9.figshare.26704998
Chen, Q., Lin, C., Wu, S., Wang, L., Chen, X., Su, L., Huang, W., & Xiao, F. (2026) · Pacing and Clinical Electrophysiology · doi:10.1111/pace.70363
RESULTS OF THE REGIONAL PROJECT “KUZBASS WITHOUT ARRHYTHMIA”
Захирович, Х. З., Mamchur, S. E., Gorbunova, E. V., Altymysheva, A. N., Александровна, А. Т., & Kleshcheva, A. V. (2026) · Complex Issues of Cardiovascular Diseases · doi:10.17802/2306-1278-2026-15-1-174-179
Klassifikationen, Erkrankungsverläufe und Symptomatologie
CARLSSON, J., NEUZNER, J., & Erdogan, A. R. (2007) · Steinkopff eBooks · doi:10.1007/978-3-7985-1748-6_3
Influence of Age, Sex and Episode Recurrence on Quality of Life in Atrial Fibrillation
Reynolds, M. R., & Fein, A. S. (2009) · Springer eBooks · doi:10.1007/978-0-387-78665-0_175
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
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
