Cited by 2,100Atrial Fibrillation Management and OutcomesAcute Ischemic Stroke ManagementCardiac pacing and defibrillation studies

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Subclinical Atrial Fibrillation and the Risk of Stroke

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Healey, Jeff S., Connolly, Stuart J., Gold, Michael R., Israel, Carsten W., Van Gelder, Isabelle C., Capucci, Alessandro, Lau, C.P., Fain, Eric, Yang, Sean, Bailleul, Christophe, Morillo, Carlos A., Carlson, Mark, Themeles, Ellison, Kaufman, Elizabeth S., Hohnloser, Stefan H.·2012·New England Journal of Medicine

DOI 10.1056/nejmoa1105575

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Abstract

BACKGROUND: One quarter of strokes are of unknown cause, and subclinical atrial fibrillation may be a common etiologic factor. Pacemakers can detect subclinical episodes of rapid atrial rate, which correlate with electrocardiographically documented atrial fibrillation. We evaluated whether subclinical episodes of rapid atrial rate detected by implanted devices were associated with an increased risk of ischemic stroke in patients who did not have other evidence of atrial fibrillation. METHODS: We enrolled 2580 patients, 65 years of age or older, with hypertension and no history of atrial fibrillation, in whom a pacemaker or defibrillator had recently been implanted. We monitored the patients for 3 months to detect subclinical atrial tachyarrhythmias (episodes of atrial rate >190 beats per minute for more than 6 minutes) and followed them for a mean of 2.5 years for the primary outcome of ischemic stroke or systemic embolism. Patients with pacemakers were randomly assigned to receive or not to receive continuous atrial overdrive pacing. RESULTS: By 3 months, subclinical atrial tachyarrhythmias detected by implanted devices had occurred in 261 patients (10.1%). Subclinical atrial tachyarrhythmias were associated with an increased risk of clinical atrial fibrillation (hazard ratio, 5.56; 95% confidence interval [CI], 3.78 to 8.17; P<0.001) and of ischemic stroke or systemic embolism (hazard ratio, 2.49; 95% CI, 1.28 to 4.85; P=0.007). Of 51 patients who had a primary outcome event, 11 had had subclinical atrial tachyarrhythmias detected by 3 months, and none had had clinical atrial fibrillation by 3 months. The population attributable risk of stroke or systemic embolism associated with subclinical atrial tachyarrhythmias was 13%. Subclinical atrial tachyarrhythmias remained predictive of the primary outcome after adjustment for predictors of stroke (hazard ratio, 2.50; 95% CI, 1.28 to 4.89; P=0.008). Continuous atrial overdrive pacing did not prevent atrial fibrillation. CONCLUSIONS: Subclinical atrial tachyarrhythmias, without clinical atrial fibrillation, occurred frequently in patients with pacemakers and were associated with a significantly increased risk of ischemic stroke or systemic embolism. (Funded by St. Jude Medical; ASSERT ClinicalTrials.gov number, NCT00256152.).

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Gage, B. F., Waterman, A. D., Shannon, W., Boechler, M., Rich, M. W., & Radford, M. J. (2001) · JAMA · doi:10.1001/jama.285.22.2864 · Cited by 4,832
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Wolf, P. A., Dawber, T. R., Thomas, H. E., & Kannel, W. B. (1978) · Neurology · doi:10.1212/wnl.28.10.973 · Cited by 1,526
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Wolf, P. A. (1987) · Archives of Internal Medicine · doi:10.1001/archinte.1987.00370090041008 · Cited by 1,108
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Chyou, J. Y., Hunter, T. D., Mollenkopf, S. A., Turakhia, M. P., & Reynolds, M. R. (2015) · Journal of the American Heart Association · doi:10.1161/jaha.114.001723 · Cited by 41
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Lubitz, S. A., Parsons, O., Anderson, C. D., Benjamin, E. J., Malik, R., Weng, L.-C. C., Dichgans, M., Sudlow, C. L. M., Rothwell, P. M., Rosand, J. M., et al. (2017) · Stroke · doi:10.1161/strokeaha.116.016198 · Cited by 39
Anticoagulation in device-detected atrial fibrillation with or without vascular disease: a combined analysis of the NOAH-AFNET 6 and ARTESiA trials
Schnabel, R. B., Benezet‐Mazuecos, J., Becher, N., McIntyre, W. F., Fierenz, A., Lee, S. F., Goette, A., Atar, D., Bertaglia, E., Benz, A. P., et al. (2024) · European Heart Journal · doi:10.1093/eurheartj/ehae596 · Cited by 43
“6,11 The efficacy outcomes were a composite of ischaemic stroke (including transient events with matching lesion on cerebral imaging), SE including peripheral and abdominal embolism, MI, pulmonary embolism (PE) or cardiovascular death (including unknown death), and a composite of all-cause stroke…”
Optimizing Implantable Cardioverter-Defibrillator Remote Monitoring
Ploux, S., Varma, N., Strik, M., Lazarus, A., & Bordachar, P. (2017) · JACC. Clinical electrophysiology · doi:10.1016/j.jacep.2017.02.007 · Cited by 39
Fatores de risco modificáveis e não modificáveis do AVC isquêmico: uma abordagem descritiva
Rodrigues, M. D. S., Santana, L. F. E., & Galvão, I. M. (2017) · Revista de Medicina · doi:10.11606/issn.1679-9836.v96i3p187-192 · Cited by 47
Systematic screening for atrial fibrillation in a 65-year-old population with risk factors for stroke: data from the Akershus Cardiac Examination 1950 study
Berge, T., Brynildsen, J., Larsen, H. K. N., Onarheim, S., Jenssen, G. R., Ihle‐Hansen, H., Christophersen, I. E., Myrstad, M., Røsjø, H. R., Smith, P., et al. (2017) · EP Europace · doi:10.1093/europace/eux293 · Cited by 39
Symptoms In Atrial Fibrillation: A Contemporary Review And Future Directions.
Heidt, S. T., Kratz, A. L., Najarian, K., Hassett, A. L., Oral, H., Gonzalez, R., Nallamothu, B. K., Clauw, D. J., & Ghanbari, H. (2016) · PubMed Central · doi:10.4022/jafib.1422 · Cited by 39
Are 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
Atrial fibrillation and stroke: how much atrial fibrillation is enough to cause a stroke?
Healey, J. S., Amit, G., & Field, T. S. (2019) · Current Opinion in Neurology · doi:10.1097/wco.0000000000000780 · Cited by 40
“These devices permit highly sensitive, long-term, continuous monitoring for atrial arrhythmias, even if these arrhythmias are asymptomatic and last only seconds [7,8].”
Background
Symptom severity is associated with cardiovascular outcome in patients with permanent atrial fibrillation in the RACE II study
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
Clinical significance of atrial fibrillation detected by cardiac implantable electronic devices
DeCicco, A. E., Finkel, J. B., Greenspon, A. J., & Frisch, D. R. (2014) · Heart Rhythm · doi:10.1016/j.hrthm.2014.01.001 · Cited by 38
Accuracy, Usability, and Adherence of Smartwatches for Atrial Fibrillation Detection in Older Adults After Stroke: Randomized Controlled Trial
Ding, E., Tran, K., Lessard, D., Wang, Z., Han, D., Mohagheghian, F., Otabil, E. M., Noorishirazi, K., Mehawej, J., Filippaios, A., et al. (2023) · JMIR Cardio · doi:10.2196/45137 · Cited by 39
Perioperative stroke
Fanning, J. P., Campbell, B. C. V., Bulbulia, R. A., Gottesman, R. F., Ko, S., Floyd, T. F., & Messe, S. R. (2024) · Nature Reviews Disease Primers · doi:10.1038/s41572-023-00487-6 · Cited by 39
“Although not reflective of the general population, subclinical atrial fibrillation has been reported in 10% of patients with no prior atrial fibrillation history at 3 months and 35% at 2.5 years following implantable cardiac defibrillator or pacemaker implantation 71 72 .”
Influential
Detection of subclinical atrial fibrillation with cardiac implanted electronic devices: What decision making on anticoagulation after the NOAH and ARTESiA trials?
Boriani, G., Gerra, L., Mei, D. A., Bonini, N., Vitolo, M., Proietti, M., & Imberti, J. F. (2024) · European Journal of Internal Medicine · doi:10.1016/j.ejim.2024.01.002 · Cited by 38
Na+ current expression in human atrial myofibroblasts: identity and functional roles
Koivumäki, J. T., Clark, R. B., Belke, D. D., Kondo, C. S., Fedak, P. W. M., Maleckar, M. M., & Giles, W. R. (2014) · Frontiers in Physiology · doi:10.3389/fphys.2014.00275 · Cited by 38
New Directions in Cardiac Arrhythmia Management: Present Challenges and Future Solutions
Nattel, S., Andrade, J. G., Macle, L., Rivard, L., Dyrda, K., Mondesert, B. A., & Khairy, P. (2014) · Canadian Journal of Cardiology · doi:10.1016/j.cjca.2014.09.027 · Cited by 37
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
HFpEF Is the Substrate for Stroke in Obesity and Diabetes Independent of Atrial Fibrillation
Packer, M. (2019) · JACC Heart Failure · doi:10.1016/j.jchf.2019.09.002 · Cited by 39
Predicting Atrial Fibrillation with High Risk of Embolization with Atrial Strain and NT-proBNP
Pagola, J., Juega, J., Pascual, J. F., Bustamante, A., Peñalba, A., Palà, E., Rodriguez, M., de Lera, M., Arenillas, J. F., Cabezas, J. A., et al. (2020) · Translational Stroke Research · doi:10.1007/s12975-020-00873-2 · Cited by 39
Atrial fibrillation burden: an update—the need for a CHA2DS2-VASc-AFBurden score
Tiver, K. D., Quah, J. X., Lahiri, A., Ganesan, A. N., & McGavigan, A. D. (2020) · EP Europace · doi:10.1093/europace/euaa287 · Cited by 40
2021 ISHNE/HRS/EHRA/APHRS collaborative statement on mHealth in Arrhythmia Management: Digital Medical Tools for Heart Rhythm Professionals
Varma, N., Cygankiewicz, I., Turakhia, M. P., Heidbüchel, H., Hu, Y., Chen, L. Y., Couderc, J., Cronin, E. M., Estep, J. D., Grieten, L., et al. (2021) · Journal of Arrhythmia · doi:10.1002/joa3.12461 · Cited by 37
How much atrial fibrillation is too much atrial fibrillation?
Lamas, G. (2012) · New England Journal of Medicine · doi:10.1056/nejme1111948 · Cited by 36
2025 Clinical practice guidelines for Atrial fibrillation and flutter
Golukhova, E. Z., Sp, G., Михайлов, Е. Н., Revishvili, A. S. H., Arakelyan, M. G., Vasilyeva, E. Y., Davtyan, K. V., Drapkina, O. M., Drozdova, L. Y., Станиславовна, К. Е., et al. (2026) · Russian Journal of Cardiology · doi:10.15829/1560-4071-2025-6668 · Cited by 44
Silent ischaemic brain lesions related to atrial high rate episodes in patients with cardiac implantable electronic devices
Benezet‐Mazuecos, J., Campal, J. M. R., Cortés, M., Iglesias, J. A., Calle, S., de la Vieja, J. J., Quinones, M. A., Sanchez-Borque, P., de la Cruz, E., Espejo, A., et al. (2014) · EP Europace · doi:10.1093/europace/euu267 · Cited by 37
Accuracy of patient perception of their prevailing rhythm: A comparative analysis of monitor data and questionnaire responses in patients with atrial fibrillation
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
Dynamic Analysis of Cardiac Rhythms for Discriminating Atrial Fibrillation From Lethal Ventricular Arrhythmias
DeMazumder, D., Lake, D. E., Cheng, A., Moss, T. J., Güallar, E., Weiss, R. G., Jones, S. R., Tomaselli, G. F., & Moorman, J. R. (2013) · Circulation Arrhythmia and Electrophysiology · doi:10.1161/circep.113.000034 · Cited by 37
Relation of Left Atrial Dysfunction to Ischemic Stroke in Patients With Coronary Heart Disease (from the Heart and Soul Study)
Wong, J. M., Welles, C. C., Azarbal, F., Whooley, M. A., Schiller, N. B., & Turakhia, M. P. (2014) · The American Journal of Cardiology · doi:10.1016/j.amjcard.2014.02.021 · Cited by 36
Cryptogenic stroke and atrial fibrillation in a real-world population: the role of insertable cardiac monitors
Angelis, 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
Effects of Atrial Fibrillation Screening According to N-Terminal Pro-B-Type Natriuretic Peptide: A Secondary Analysis of the Randomized LOOP Study
Xing, L. Y., Diederichsen, S. Z., Højberg, S., Krieger, D. W., Graff, C., Frikke‐Schmidt, R., OLESEN, M. S., Brandes, A., Køber, L., Haugan, K., et al. (2023) · Circulation · doi:10.1161/circulationaha.123.064361 · Cited by 39
Left Atrial Appendage Volume Increased in More Than Half of Patients with Cryptogenic Stroke
Taina, M., Vanninen, R. L., Hedman, M., Jäkälä, P., Kärkkäinen, S., Tapiola, T., & Sipola, P. (2013) · PLoS ONE · doi:10.1371/journal.pone.0079519 · Cited by 38
Silent atrial fibrillation: Definition, clarification, and unanswered issues
Kennedy, H. L. (2015) · Annals of Noninvasive Electrocardiology · doi:10.1111/anec.12307 · Cited by 32
Left Atrial Strain Predicts Subclinical Atrial Fibrillation Detected by Long-term Continuous Monitoring in Elderly High-Risk Individuals
Olsen, F. J., Diederichsen, S. Z., Jørgensen, P. G., Jensen, M. T., Dahl, A., Landler, N. E., Graff, C., Brandes, A., Krieger, D. W., Haugan, K., et al. (2024) · Circulation Cardiovascular Imaging · doi:10.1161/circimaging.123.016197 · Cited by 37
Randomized Invitation to Systematic NT-proBNP and ECG Screening in 75-Year-Olds to Detect Atrial Fibrillation: STROKESTOP II
Gudmundsdottir, K. K., Svennberg, E., Friberg, L., Hygrell, T., Frykman, V., Al‐Khalili, F., Hijazi, Z., Rosenqvist, M., & Engdahl, J. (2024) · Circulation · doi:10.1161/circulationaha.124.071176 · Cited by 36
Cost Effectiveness of Treatments for Stroke Prevention in Atrial Fibrillation: Focus on the Novel Oral Anticoagulants
Kasmeridis, C., Apostolakis, S. Z., Ehlers, L. H., Rasmussen, L. H., Boriani, G., & Lip, G. Y. H. (2013) · PharmacoEconomics · doi:10.1007/s40273-013-0090-1 · Cited by 36
Management of Atrial Fibrillation in the Year 2033: New Concepts, Tools, and Applications Leading to Personalized Medicine
Gillis, A. M., Krahn, A. D., Skanes, A. C., & Nattel, S. (2013) · Canadian Journal of Cardiology · doi:10.1016/j.cjca.2013.07.006 · Cited by 36
Clinical impact of catheter ablation in patients with asymptomatic atrial fibrillation: The IRON-AF (Italian Registry on NavX Atrial Fibrillation Ablation Procedures) study
Forleo, G. B., Martino, G. D., Mantica, M., Carreras, G., Parisi, Q., Zingarini, G., Panigada, S., Romano, E., Russo, A. D., Biase, L. D., et al. (2013) · International Journal of Cardiology · doi:10.1016/j.ijcard.2013.06.132 · Cited by 36
Natriuretic peptides for the detection of paroxysmal atrial fibrillation
Seegers, J., Zabel, M., Grüter, T., Ammermann, A., Weber-Krüger, M., Edelmann, F., Gelbrich, G., Binder, L., Herrmann‐Lingen, C., Gröschel, K., et al. (2015) · Open Heart · doi:10.1136/openhrt-2014-000182 · Cited by 36
Interatrial block predicts atrial high rate episodes detected by cardiac implantable electronic devices
Tekkeşin, A. İ., Çinier, G., Çakıllı, Y., Hayıroğlu, M. İ., & Alper, A. T. (2016) · Journal of Electrocardiology · doi:10.1016/j.jelectrocard.2016.09.004 · Cited by 36
The role of empiric superior vena cava isolation in atrial fibrillation: a systematic review and meta-analysis of randomized controlled trials
Sharma, S. P., Sangha, R. S., Dahal, K. B., & Krishnamoorthy, P. M. (2016) · Journal of Interventional Cardiac Electrophysiology · doi:10.1007/s10840-016-0198-2 · Cited by 36
A randomized trial evaluating the accuracy of AF detection by four external ambulatory ECG monitors compared to permanent pacemaker AF detection
Eysenck, W., Freemantle, N., & Sulke, N. (2019) · Journal of Interventional Cardiac Electrophysiology · doi:10.1007/s10840-019-00515-0 · Cited by 36
Cardiac mechanics and incident ischemic stroke: the Cardiovascular Health Study
Kamel, H., Bartz, T. M., Longstreth, W. T., Elkind, M. S. V., Gottdiener, J. S., Kizer, J. R., Gardin, J. M., Kim, J. J., & Shah, S. J. (2021) · Scientific Reports · doi:10.1038/s41598-021-96702-z · Cited by 35
ESC Working Group on e-Cardiology Position Paper: accuracy and reliability of electrocardiogram monitoring in the detection of atrial fibrillation in cryptogenic stroke patients
Dilaveris, P., Antoniou, C. K., Caiani, E. G., Casado-Arroyo, R., Climent, A. M., Cluitmans, M. J. M., Cowie, M., Doehner, W., Guerra, F., Jensen, M. T., et al. (2022) · European Heart Journal - Digital Health · doi:10.1093/ehjdh/ztac026 · Cited by 40
“Therefore, in patients with an implanted pacemaker/defibrillator, regular device interrogation should be performed to search for AF or subclinical atrial tachyarrhythmias, associated with a significantly increased risk of IS or systemic embolism.(35,121) Current guidelines advocate ECG verification of device-detected…”
Background
Associations of MMP-2, BAX, and Bcl-2 mRNA and Protein Expressions with Development of Atrial Fibrillation
Diao, S.-L., Xu, H., Zhang, B., Ma, B., & Liu, X.-L. (2016) · Medical Science Monitor · doi:10.12659/msm.895715 · Cited by 36
Post-operative Atrial Fibrillation - Pathophysiology, Treatment and Prevention.
Bidar, E., Bramer, S., Maesen, B. A. E., Maessen, J. G., & Schotten, U. (2013) · Europe PMC (PubMed Central) · doi:10.4022/jafib.781 · Cited by 36
The Role of Implantable Cardiac Monitors in Atrial Fibrillation Management
Ciconte, G., Giacopelli, D., & Pappone, C. (2017) · Journal of Atrial Fibrillation · doi:10.4022/jafib.1590 · Cited by 36
Management of atrial fibrillation in bradyarrhythmias
Boriani, G., & Padeletti, L. (2015) · Nature Reviews Cardiology · doi:10.1038/nrcardio.2015.30 · Cited by 35

Authors: Healey, J. S., Connolly, S. J., Gold, M. R., Israel, C. W., Van Gelder, I. C., Capucci, A., Lau, C. P., Fain, E., Yang, S., Bailleul, C., Morillo, C. A., Carlson, M., Themeles, E., Kaufman, E. S., & Hohnloser, S. H.
Affiliations: Population Health Research Institute (CA)
Medical University of South Carolina (US)
Goethe University Frankfurt (DE)
Marche Polytechnic University (IT)
Queen Mary Hospital (CN)
MetroHealth (US)
ORCID: Healey, Jeff S.
Connolly, Stuart J.
Gold, Michael R.
Israel, Carsten W.
Capucci, Alessandro
Fain, Eric
Bailleul, Christophe
Morillo, Carlos A.
Kaufman, Elizabeth S.
Hohnloser, Stefan H.
Venue: New England Journal of Medicine
Publisher: Massachusetts Medical Society
Published: 2012-01-12
Volume: 366
Issue: 2
Pages: 120-129
ISSN: 0028-4793 (ISSN-L)
1533-4406
DOI: 10.1056/nejmoa1105575
OpenAlex: W2154658516
Cited by: 2,100
References: 37
Citations by year: 2026: 87 · 2025: 104 · 2024: 137 · 2023: 116 · 2022: 134 · 2021: 153 · 2020: 148 · 2019: 162 · 2018: 154 · 2017: 154 · 2016: 162 · 2015: 146 · 2014: 181 · 2013: 133 · 2012: 124
FWCI: 120.21
Type: journal article
Language: en
Open access: bronze
doi.org
Locations: New England Journal of Medicine (publishedVersion)
PubMed (publishedVersion)
University of Groningen research database (University of Groningen / Centre for Information Technology) (publishedVersion)
Università Politecnica delle Marche (Università Politecnica delle Marche) (submittedVersion)
University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion)
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: subclinical atrial fibrillation, atrial tachyarrhythmia, ischemic stroke, systemic embolism, atrial overdrive pacing, atrial fibrillation risk, hypertension, elderly patients, population attributable risk, stroke prevention, cardiac implantable electronic devices, atrial fibrillation detection, atrial fibrillation prevention
MeSH terms: Aged, Aged, 80 and over, Atrial Fibrillation, Cardiac Pacing, Artificial, Embolism, Female, Humans, Hypertension, Male, Pacemaker, Artificial, Prospective Studies, Risk, Defibrillators, Implantable, Stroke

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Subclinical Atrial Fibrillation and the Risk of Stroke

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