Cited by 627Atrial Fibrillation Management and OutcomesCardiac Arrhythmias and TreatmentsCardiac electrophysiology and arrhythmias

The DOI matches its Crossref record.

Asymptomatic arrhythmias in patients with symptomatic paroxysmal atrial fibrillation and paroxysmal supraventricular tachycardia

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

Open this paper in CoChat — free account

Abstract

BACKGROUND: Paroxysmal atrial fibrillation and paroxysmal supraventricular tachycardia are recognized clinically when patients seek treatment for symptoms due to recurrent arrhythmias; atrial fibrillation also increases the risk of stroke. The frequency with which asymptomatic arrhythmias occur in patients with these arrhythmias is unknown. METHODS AND RESULTS: Twenty-two patients with paroxysmal atrial fibrillation (n = 8) or paroxysmal supraventricular tachycardia (n = 14) were studied for 29 days with two different ambulatory ECG-monitoring techniques to measure the relative frequency of asymptomatic and symptomatic arrhythmias. All class I antiarrhythmic drugs, calcium channel blockers, beta-blockers, and digitalis were withheld. Sustained asymptomatic arrhythmia events (defined as lasting at least 30 seconds) were documented using continuous ambulatory ECG monitoring once weekly for a total of 5 of the 29 study days; symptomatic arrhythmia events were documented using transtelephonic ECG monitoring for all 29 days of the study. In the group of patients with paroxysmal atrial fibrillation, asymptomatic arrhythmia events occurred significantly more frequently than symptomatic arrhythmia events; the mean rates, expressed as events/100 d/patient (95% confidence interval), were 62.5 (40.4, 87.3) and 5.2 (2.7, 9.0) (P < .01); the ratio of the mean rates was 12.1 (5.8, 26.4). In contrast, in the group of patients with paroxysmal supraventricular tachycardia, asymptomatic arrhythmia events were significantly less frequent than symptomatic arrhythmia events; the mean rates were 0.0 (0.0, 5.3) and 7.4 (5.0, 10.6) (P = .02). The ratio of the mean rates was 0.0 (0.0, 0.8). CONCLUSIONS: In a group of patients with paroxysmal atrial fibrillation, sustained asymptomatic atrial fibrillation occurs far more frequently than symptomatic atrial fibrillation. However, it is not known whether asymptomatic atrial fibrillation is a potential risk factor for stroke even when patients are not having symptomatic arrhythmias.

Integrity signals

Registry

Crossref · 10.1161/01.cir.89.1.224

Cites

Statistics

Recomputing p-values needs the paper’s full text.

Claims the paper makes

This paper’s full text isn’t openly available, so its claims and self-check weren’t run. The registry and citation checks still apply.

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?

Sorted by citations

Items 101–200 of 622

Follow-up of atrial fibrillation: The initial experience of the Canadian Registry of Atrial Fibrillation
Kerr, C. R., Boone, J. A., Connolly, S. J., Greene, M., Klein, G. J., Sheldon, R. S., & Talajic, M. R. (1996) · European Heart Journal · doi:10.1093/eurheartj/17.suppl_c.48 · Cited by 108
Patterns and Predictors of Warfarin Use in Patients With New-Onset Atrial Fibrillation from the FRACTAL Registry
Reynolds, M. R., Shah, J. S., Essebag, V., Olshansky, B., Friedman, P. A., Hadjis, T., Lemery, R., Bahnson, T. D., Cannom, D. S., Josephson, M. E., et al. (2006) · The American Journal of Cardiology · doi:10.1016/j.amjcard.2005.09.086 · Cited by 104
Short-term ECG for out of hospital detection of silent atrial fibrillation episodes
Doliwa, P. S., Frykman, V., & Rosenqvist, M. (2009) · Scandinavian Cardiovascular Journal · doi:10.1080/14017430802593435 · Cited by 105
“With improved methods of cardiac rhythm monitoring it has also been shown that the prevalence of paroxysmal atrial fibrillation is higher than previously assumed (4,9) and may, furthermore, carry the same risk for stroke as does permanent atrial fibrillation (12,13).”
Method
Efficacy and safety of sustained-release propafenone (propafenone SR) for patients with atrial fibrillation
Pritchett, E. L. C., Page, R. L., Carlson, M. D., Undesser, K. P., & Fava, G. (2003) · The American Journal of Cardiology · doi:10.1016/s0002-9149(03)00974-3 · Cited by 105
Self-citation
Antiarrhythmic effects of azimilide in atrial fibrillation: efficacy and dose-response
Pritchett, E. L. C., Page, R. L., Connolly, S. J., Marcello, S. R., Schnell, D., & Wilkinson, W. E. (2000) · Journal of the American College of Cardiology · doi:10.1016/s0735-1097(00)00773-7 · Cited by 102
“Lenis, MD, Peter Carmichael, RN, Nathalie Pilon, RN, INVASCOR Clinical Research (6), Longueuil, Quebec, Canada; Alan Mobley, MD, Bonnie Stevens (6), Conroe, Texas; Melvin Tonkon, FACC, FACP, MD, Cathy Fox, BS, Anaheim Heart and Research Institute (6), Anaheim, California; Jerome Blumenthal, MD, Jean Warren, RCVT, Card…”
BackgroundInfluentialSelf-citation
Atrial 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
“Data suggest that asymptomatic PAF episodes occur with much greater frequency than symptomatic PAF.7 Recent studies have focused on establishing the frequency of short asymptomatic episodes of AF, which have been termed atrial high-rate episodes (AHREs).”
Background
Prevention of Atrial Arrhythmias during DDD Pacing by Atrial Overdrive
Garrigue, S., Barold, S. S., Cazeau, S., et al. (1998) · Pacing and Clinical Electrophysiology · doi:10.1111/j.1540-8159.1998.tb00275.x · Cited by 103
“The sequence involves two stages; (1) a temporary diagnostic phase lasting 30 seconds during which the AV synchrony is limited to 120 ppm or the programmed npper rate if slower; and [2) a fallback phase when the DDD mode is converted to the VVI (strictly the VDI) mode with a gradual reduction in the pacing rate to 70…”
Method
Accuracy of Mode Switch Algorithms for Detection of Atrial Tachyarrhythmias
PASSMAN, R. S., Weinberg, K. M., Freher, M., Schaechter, A., Goldberger, J. J., & Kadish, A. H. (2004) · Journal of Cardiovascular Electrophysiology · doi:10.1046/j.1540-8167.2004.03537.x · Cited by 101
Frequent and Prolonged Asymptomatic Episodes of Paroxysmal Atrial Fibrillation Revealed by Automatic Long‐Term Event Recorders in Patients with a Negative 24‐Hour Holter
Roche, F., Gaspoz, J., Costa, A. D., Isaaz, K., Duverney, D., Pichot, V., Costes, F., Lacour, J.-R., & Barthélemy, J. (2002) · Pacing and Clinical Electrophysiology · doi:10.1046/j.1460-9592.2002.01587.x · Cited by 101
“There are six categories of premature events, the degree of prematurity of which is user-defined: (1) narrow single premature beats, (2) wide single premature beats, (3) 2–5 consecutive narrow premature beats, (4) 2–5 consecutive wide premature beats, (5) 6 or more consecutive narrow premature beats, and (6) 6 or more…”
Background
Trends in Hospitalization for Atrial Fibrillation: Epidemiology, Cost, and Implications for the Future
Sheikh, A. B., Patel, N., Nalluri, N., Agnihotri, K., Spagnola, J., Patel, A., Asti, D., Kanotra, R., Khan, H., Savani, C., et al. (2015) · Progress in Cardiovascular Diseases · doi:10.1016/j.pcad.2015.07.002 · Cited by 99
“paroxysmal AF), the annual prevalence of AF is likely to be underestimated.(17)”
State of the Science: The Relevance of Symptoms in Cardiovascular Disease and Research: A Scientific Statement From the American Heart Association
Jurgens, C. Y., Lee, C. S., Aycock, D. M., Creber, R. M., Denfeld, Q. E., DeVon, H. A., Evers, L. R., Jung, M., Pucciarelli, G., Streur, M. M., et al. (2022) · Circulation · doi:10.1161/cir.0000000000001089 · Cited by 110
Management of atrial fibrillation: Figure 1
Lip, G. Y. H., & Tello-Montoliu, A. (2006) · Heart · doi:10.1136/hrt.2005.071555 · Cited by 99
A Comparison of Atrial Fibrillation Monitoring Strategies After Cryptogenic Stroke (from the Cryptogenic Stroke and Underlying AF Trial)
Choe, W. C., PASSMAN, R. S., Brachmann, J., Morillo, C. A., Sanna, T., Bernstein, R. A., Lazzaro, V. D., Diener, H., Rymer, M. M., Beckers, F., et al. (2015) · The American Journal of Cardiology · doi:10.1016/j.amjcard.2015.06.012 · Cited by 98
Detection of atrial fibrillation episodes using a wristband device
Corino, V., Laureanti, R., Ferranti, L., Scarpini, G., Lombardi, F., & Mainardi, L. T. (2017) · Physiological Measurement · doi:10.1088/1361-6579/aa5dd7 · Cited by 95
“Auton Neurosci 151, 147–53 (2009) [24] Page, R.”
Background
Event‐Recorder Monitoring in the Diagnosis of Atrial Fibrillation in Symptomatic Patients: Subanalysis of the SOPAT Trial
Patten, M., Maas, R., Karim, A., MÜLLER, H., SIMONOVSKY, R., & Meinertz, T. (2006) · Journal of Cardiovascular Electrophysiology · doi:10.1111/j.1540-8167.2006.00609.x · Cited by 95
Interpreting changes in quality of life in atrial fibrillation: How much change is meaningful?
Dorian, P., Burk, C., Mullin, C. M., Bubien, R., Godejohn, D., Reynolds, M. R., Lakkireddy, D. R., Wimmer, A. P., Bhandari, A., & Spertus, J. (2013) · American Heart Journal · doi:10.1016/j.ahj.2013.04.015 · Cited by 95
Stroke in atrial fibrillation: epidemiology and thromboprophylaxis
Lip, G. Y. H. (2011) · Journal of Thrombosis and Haemostasis · doi:10.1111/j.1538-7836.2011.04302.x · Cited by 91
Diagnosis of Paroxysmal Atrial Fibrillation in Patients with Implanted Pacemakers: Relationship to Symptoms and Other Variables
Quirino, G., Giammaria, M., CORBUCCI, G., Pistelli, P., Turri, E., Mazza, A., Perucca, A., Checchinato, C., Dalmasso, M., & Barold, S. S. (2008) · Pacing and Clinical Electrophysiology · doi:10.1111/j.1540-8159.2009.02181.x · Cited by 89
Atrial fibrillation: review of current treatment strategies
Xu, J., Luc, J. G. Y., & Phan, K. H. (2016) · Journal of Thoracic Disease · doi:10.21037/jtd.2016.09.13 · Cited by 88
“However, not all types of AF are symptomatic, with paroxysmal AF patients more frequently being asymptomatic (31).”
Background
Stroke as the First Manifestation of Atrial Fibrillation
Jaakkola, J., Mustonen, P. E., Kiviniemi, T., Hartikainen, J. E. K., Palomäki, A., Hartikainen, P. H., Nuotio, I. O., Ylitalo, A., & Airaksinen, J. K. E. (2016) · PLoS ONE · doi:10.1371/journal.pone.0168010 · Cited by 84
Monitoring long-term cardiac activity with contactless radio frequency signals
Zhang, B., Zhang, D., Li, Y., Lu, Z. P., Chen, J., Wang, H., Zhou, F., Pu, Y., Hu, Y., Ma, L., et al. (2024) · Nature Communications · doi:10.1038/s41467-024-55061-9 · Cited by 92
“Moreover, the high-order harmonics of the heartbeat present in the high-frequency component exhibit the beat frequency effect, resulting in highly complete and accurate heartbeat patterns (see the principle of beat frequency effect in Supplementary Note 4 and Fig.”
Influential
Markers of inflammation before and after curative ablation of atrial flutter
Marcus, G. M., Smith, L. M., Glidden, D. V., Wilson, E., McCabe, J. M., Whiteman, D., Tseng, Z. H., Badhwar, N., Lee, B. K., Lee, R. J., et al. (2007) · Heart Rhythm · doi:10.1016/j.hrthm.2007.10.007 · Cited by 83
A novel, simple scale for assessing the symptom severity of atrial fibrillation at the bedside: The CCS-SAF Scale
Dorian, P., Cvitkovic, S., Kerr, C. R., Crystal, E., Gillis, A. M., Guerra, P. G., Mitchell, L. B., Roy, D., Skanes, A. C., & Wyse, D. G. (2006) · Canadian Journal of Cardiology · doi:10.1016/s0828-282x(06)70922-9 · Cited by 87
“For example, most patients with persistent or permanent AF do not have continuous symptoms, and many with symptomatic paroxysmal AF have as many or more asymptomatic episodes than symptomatic ones (9).”
Background
Atrial Fibrillation and Atrial Flutter in Pregnant Women—A Population‐Based Study
Lee, M. S., Chen, W., Zhang, Z., Duan, L., Ng, A., Spencer, H. T., Kwan, D. M., & Shen, A. Y. (2016) · Journal of the American Heart Association · doi:10.1161/jaha.115.003182 · Cited by 85
The History of Atrial Fibrillation: The Last 100 Years
Prystowsky, E. N. (2008) · Journal of Cardiovascular Electrophysiology · doi:10.1111/j.1540-8167.2008.01184.x · Cited by 81
Prospective, multicentre validation of a simple, patient-operated electrocardiographic system for the detection of arrhythmias and electrocardiographic changes
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
“Detection of asymptomatic atrial fibrillation Atrial fibrillation is likely to be asymptomatic in at least half of the episodes,1– 3,19 and ischaemic stroke or other complications are often the first clinical manifestation of asymptomatic AF.20– 22 A simple, patient-activated ECG monitor would allow to screen for AF i…”
BackgroundInfluential
Paroxysmal A trial Fibrillation:
Lévy, S., Novella, P., Ricard, P., & Paganelli, F. F. (1995) · Journal of Cardiovascular Electrophysiology · doi:10.1111/j.1540-8167.1995.tb00758.x · Cited by 83
Double-Blind Placebo-Controlled Trial of Digoxin in Symptomatic Paroxysmal Atrial Fibrillation
MURGATROYD, F. D., Gibson, S., Baiyan, X., O'Nunain, S. S., Poloniecki, J. D., Ward, D. E., Malík, M., & Camm, A. J. (1999) · Circulation · doi:10.1161/01.cir.99.21.2765 · Cited by 80
“cause for AF (3), pacemaker (3), patient refusal (22), physi-”
Background
Outpatient cardioversion of atrial arrhythmias: Efficacy, safety, and costs
Botkin, S., Dhanekula, L. S., & Olshansky, B. (2003) · American Heart Journal · doi:10.1067/mhj.2003.112 · Cited by 77
Modes of initiation of paroxysmal atrial fibrillation from analysis of spontaneously occurring episodes using a 12-lead Holter monitoring system
Kolb, C., Nürnberger, S., Ndrepepa, G., Zrenner, B., Schömig, A., & Schmitt, C. (2001) · The American Journal of Cardiology · doi:10.1016/s0002-9149(01)01891-4 · Cited by 75
Clinical Epidemiology of Atrial Fibrillation and Related Cerebrovascular Events in the United States
Lakshminarayan, K., Anderson, D. C., Herzog, C. A., & Qureshi, A. I. (2008) · The Neurologist · doi:10.1097/nrl.0b013e31815cffae · Cited by 82
“This is likely an underestimate because many patients with paroxysmal AF remain asymptomatic, hence undetected.(5,7,8) Investigators for the Anticoagulation and Risk Factors in Atrial Fibrillation study projected a 2.”
Background
Gene expression profile associated with chronic atrial fibrillation and underlying valvular heart disease in man
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
An Efficient ECG Classification System Using Resource-Saving Architecture and Random Forest
Kung, B.-H., Hu, P.-Y., Huang, C.-C., Lee, C.-C., Yao, C.-Y., & Kuan, C.-H. (2020) · IEEE Journal of Biomedical and Health Informatics · doi:10.1109/jbhi.2020.3035191 · Cited by 74
Intermittent short ECG recording is more effective than 24-hour Holter ECG in detection of arrhythmias
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
“example, it is known that only one in 10 paroxysms is symptomatic [7].”
Background
Asymptomatic 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
“(2,3) In pacemaker and ICD patients without a clinical diagnosis of AF, but at risk for AF, the incidence of (short) episodes of high atrial rates and silent AF is even higher.(4,5) At present it remains uncertain why some patients with AF are asymptomatic and others are symptomatic, and whether presence of symptoms i…”
BackgroundInfluential
Usefulness of Frequent Supraventricular Extrasystoles and a High CHADS2 Score to Predict First-Time Appearance of Atrial Fibrillation
Suzuki, S. S., Sagara, K., Otsuka, T., Kano, H., Matsuno, S., Takai, H., Uejima, T., Oikawa, Y., Koike, A., Nagashima, K., et al. (2013) · The American Journal of Cardiology · doi:10.1016/j.amjcard.2013.01.335 · Cited by 70
Understanding atrial symptom reports: objective versus subjective predictors
SEARS, S. F., SERBER, E. R., ALVAREZ, L. G., SCHWARTZMAN, D. S., HOYT, R. H., & UJHELYI, M. R. (2005) · Pacing and Clinical Electrophysiology · doi:10.1111/j.1540-8159.2005.00171.x · Cited by 70
Guías de práctica clínica de la Sociedad Española de Cardiología en arritmias cardíacas
Garrote, J. A., Huerta, E. M., Moreno, O. M., Peinado, R., Álvarez, L. P., Granell, R. R., & Viñolas, X. (2001) · Revista Española de Cardiología · doi:10.1016/s0300-8932(01)76313-0 · Cited by 71
Effects of C-Reactive Protein and the Third and Fourth Components of Complement (C3 and C4) on Incidence of Atrial Fibrillation
Dernellis, J. M., & Panaretou, M. (2005) · The American Journal of Cardiology · doi:10.1016/j.amjcard.2005.08.027 · Cited by 70
Analysis of the cardiac rhythm preceding episodes of paroxysmal atrial fibrillation
Hnatkova, K., Waktare, J. E. P., MURGATROYD, F. D., Guo, X., Baiyan, X., Camm, A. J., & Malík, M. (1998) · American Heart Journal · doi:10.1016/s0002-8703(98)70066-3 · Cited by 70
Paroxysmal Atrial Fibrillation Is More Prevalent than Persistent Atrial Fibrillation in Acute Stroke and Transient Ischemic Attack Patients
Rizos, T., Wagner, A., Jenetzky, E., Ringleb, P. A., Becker, R., Hacke, W., & Veltkamp, R. C. (2011) · Cerebrovascular Diseases · doi:10.1159/000330348 · Cited by 69
Unexpected low prevalence of atrial fibrillation in cryptogenic ischemic stroke: a prospective study
Dion, F., Saudeau, D., Bonnaud, I., Friocourt, P., Bonneau, A., Poret, P., Giraudeau, B., Régina, S., Fauchier, L., & Babuty, D. (2010) · Journal of Interventional Cardiac Electrophysiology · doi:10.1007/s10840-010-9485-5 · Cited by 67
Management of Atrial Fibrillation in Adults: Prevention of Thromboembolism and Symptomatic Treatment
Blackshear, J. L., Kopecky, S. L., Litin, S. C., Safford, R. E., & Hammill, S. C. (1996) · Mayo Clinic Proceedings · doi:10.4065/71.2.150 · Cited by 67
NATIONAL RUSSIAN GUIDELINES ON APPLICATION OF THE METHODS OF HOLTER MONITORING IN CLINICAL PRACTICE
Makarov, L. M., Komolyatova, V. N., Kupriyanova, O. A., Pervova, E. V., Ryabykina, G. V., Sobolev, A. V., Тихоненко, В. М., Туров, А. Н., Shubik, Y. V., Av, A., et al. (2014) · Russian Journal of Cardiology · doi:10.15829/1560-4071-2014-2-6-71 · Cited by 70
Contemporary Management of Atrial Fibrillation: Update on Anticoagulation and Invasive Management Strategies
Crandall, M. A., Bradley, D. J., Packer, D. L., & Asirvatham, S. J. (2009) · Mayo Clinic Proceedings · doi:10.4065/84.7.643 · Cited by 79
Prevalence of palpitations, cardiac arrhythmias and their associated risk factors in ambulant elderly
Lok, N.-S., & Lau, C.-P. (1996) · International Journal of Cardiology · doi:10.1016/0167-5273(96)02601-0 · Cited by 62
Comparison between electrocardiogram- and photoplethysmogram-derived features for atrial fibrillation detection in free-living conditions
Eerikäinen, L. M., Bonomi, A. G., Schipper, F., Dekker, L. R. C., Vullings, R., de Morree, H. M., & Aarts, R. M. (2018) · Physiological Measurement · doi:10.1088/1361-6579/aad2c0 · Cited by 61
Paroxysmal Atrial Fibrillation
Aboaf, A. P. (1996) · Archives of Internal Medicine · doi:10.1001/archinte.1996.00440040024003 · Cited by 61
Patients with postoperative atrial fibrillation have a doubled cardiovascular mortality
Ahlsson, A., Bodin, L., Fengsrud, E., & Englund, A. (2009) · Scandinavian Cardiovascular Journal · doi:10.1080/14017430802702291 · Cited by 61
“Furthermore, it is known that in patients with paroxysmal AF, asymptomatic episodes of AF may be more common than symptomatic episodes (13).”
Background
Diretrizes para Avaliação e Tratamento de Pacientes com Arritmias Cardíacas
Feitosa, G. S., Nicolau, J. C., Lorga, A. M., Filho, A. L., d’Ávila, A., Rassi, A., de Paola, Â. A. V., Pedrosa, A., da Costa, Á. B., Péres, A. K., et al. (2002) · Arquivos Brasileiros de Cardiologia · doi:10.1590/s0066-782x2002001900001 · Cited by 71
New Insights Into the Initiation of Atrial Fibrillation
Hoffmann, E., Sulke, N., Edvardsson, N. G., Ruiter, J. H., Lewalter, T., Capucci, A., Schuchert, A., Janko, S., & Camm, A. J. (2006) · Circulation · doi:10.1161/circulationaha.105.568568 · Cited by 61
“74), 50 (21; 311) versus 48 (16; 222) PACs per hour (P 0.”
Cryptogenic stroke: Is silent atrial fibrillation the culprit?
Glotzer, T. V., & Ziegler, P. (2014) · Heart Rhythm · doi:10.1016/j.hrthm.2014.09.058 · Cited by 63
Is there a role for remodeled connexins in AF? No simple answers
Duffy, H. S., & Wit, A. L. (2007) · Journal of Molecular and Cellular Cardiology · doi:10.1016/j.yjmcc.2007.08.016 · Cited by 60
“Many initial AF episodes have short durations of seconds or minutes and are asymptomatic [6,19] However, with time, AF eventually may become long lasting or persistent, hence the phrase “atrial fibrillation begets atrial fibrillation“ [20].”
Background
Utility of Mobile Cardiac Outpatient Telemetry for the Diagnosis of Palpitations, Presyncope, Syncope, and the Assessment of Therapy Efficacy
OLSON, J. A., FOUTS, A. M., PADANILAM, B. J., & PRYSTOWSKY, E. N. (2007) · Journal of Cardiovascular Electrophysiology · doi:10.1111/j.1540-8167.2007.00779.x · Cited by 59
Challenges in the classification of atrial fibrillation
Lubitz, S. A., Benjamin, E. J., Ruskin, J. N., Fuster, V., & Ellinor, P. T. (2010) · Nature Reviews Cardiology · doi:10.1038/nrcardio.2010.86 · Cited by 58
Is Dual Site Better Than Single Site Atrial Pacing in the Prevention of Atrial Fibrillation?
Leclercq, J.-F., SISTI, A. D., FIORELLO, P., Halimi, F., MANOT, S., & ATTUEL, P. (2000) · Pacing and Clinical Electrophysiology · doi:10.1111/j.1540-8159.2000.tb00783.x · Cited by 59
Optimizing Atrial Fibrillation Management
Walkey, A. J., Hogarth, D. K., & Lip, G. Y. H. (2015) · CHEST Journal · doi:10.1378/chest.15-0358 · Cited by 57
Stroke event rates in anticoagulated patients with paroxysmal atrial fibrillation
Lip, G. Y. H., Frison, L., Grind, M., & the SPORTIF Investigators (2008) · Journal of Internal Medicine · doi:10.1111/j.1365-2796.2007.01909.x · Cited by 58
Timing of First Recurrence of Syncope Predicts Syncopal Frequency After a Positive Tilt Table Test Result
Malik, P. G., Koshman, M. L., & Sheldon, R. S. (1997) · Journal of the American College of Cardiology · doi:10.1016/s0735-1097(97)00047-8 · Cited by 57
Long-term continuous external electrocardiographic recording: a review
Enseleit, F., & Duru, F. (2006) · EP Europace · doi:10.1093/europace/euj054 · Cited by 60
“The prevalence is probably greatly underestimated, as data from Holter monitoring suggest that many AF episodes are asymptomatic.(45) In patients aged 70 with AF, symptomatic cerebral infarctions are 2.”
Background
Are implantable cardiac monitors the ‘gold standard’ for atrial fibrillation detection? A prospective randomized trial comparing atrial fibrillation monitoring using implantable cardiac monitors and DDDRP permanent pacemakers in post atrial fibrillation ablation patients
Podd, S. J., Sugihara, C., FURNISS, S. S., & Sulke, N. (2015) · EP Europace · doi:10.1093/europace/euv367 · Cited by 58
“Many previous studies have shown the superiority of the ICM over spot, 24 h, 7-day ECG monitoring and telephonic monitoring at detecting recurrences of AF.21 This study has revealed some of the weaknesses of ICMs in AF burden evaluation compared with PPM.”
BackgroundInfluential
Temporal patterns of paroxysmal atrial fibrillation following DDDR pacemaker implantation
Gillis, A. M., & Rose, M. S. (2000) · The American Journal of Cardiology · doi:10.1016/s0002-9149(00)00792-x · Cited by 55
Real-World Experience with Insertable Cardiac Monitors to Find Atrial Fibrillation in Cryptogenic Stroke
Ziegler, P., Rogers, J., Ferreira, S. W., Nichols, A. J., Sarkar, S., Koehler, J. L., Warman, E. N., & Richards, M. (2015) · Cerebrovascular Diseases · doi:10.1159/000439063 · Cited by 48
Rare Variants in GJA5 Are Associated With Early-Onset Lone Atrial Fibrillation
Christophersen, I. E., Holmegard, H. N., Jabbari, J., Haunsø, S., Tveit, A., Svendsen, J. H., & OLESEN, M. S. (2012) · Canadian Journal of Cardiology · doi:10.1016/j.cjca.2012.08.002 · Cited by 50
New Appraisal of Atrial Fibrillation Burden and Stroke Prevention
PASSMAN, R. S., & Bernstein, R. A. (2016) · Stroke · doi:10.1161/strokeaha.115.009930 · Cited by 52
“Approximately 40% of patients with AF are completely asymptomatic and those who do experience symptoms are aware of only 5% to 20% of episodes.(20,21) The relevance of this for stroke neurologists is that one quarter of all AF does not become symptomatic except by causing a stroke.”
Background
Early Detection and Treatment of Atrial Arrhythmias Alleviates the Arrhythmic Burden in Paced Patients: The SETAM Study
Amara, W., Montagnier, C., Cheggour, S., Boursier, M., Gully, C., BARNAY, C., Georger, F., Deplagne, A., Fromentin, S., Młotek, M., et al. (2017) · Pacing and Clinical Electrophysiology · doi:10.1111/pace.13062 · Cited by 49
“Other conduction defects 19 (3) 10 (3) 9 (3.”
BackgroundMethodInfluential
A Review of Atrial Fibrillation Detection Methods as a Service
Faust, O., Ciaccio, E. J., & Acharya, U. R. (2020) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph17093093 · Cited by 52
“The occurrence of symptomatic episodes in paroxysmal AF is uncertain [90,91].”
Background
Artificial Intelligence for the Detection and Treatment of Atrial Fibrillation
Harmon, D., Sehrawat, O., Maanja, M., Wight, J., & Noseworthy, P. A. (2023) · Arrhythmia & Electrophysiology Review · doi:10.15420/aer.2022.31 · Cited by 52
Atrial fibrillation with symptoms other than palpitations: incremental diagnostic sensitivity with at-home tele-cardiology assessment for emergency medical service
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
“The reported incidence of symptomatic AF depends on the monitoring frequency and the burden of AF on the cohort studied.5 In a study by Camm et al. among asymptomatic elderly patients, the incidence of AF detected by a 24-hour ambulatory monitor was 10.5%.10 In a prospective study with persistent AF, 68% were symptoma…”
BackgroundInfluential
Frequency, Duration, and Predictors of Newly-Diagnosed Atrial Fibrillation Following Dual-Chamber Pacemaker Implantation in Patients Without a Previous History of Atrial Fibrillation
Mittal, S., Steín, K. M., Gilliam, F. R., Kraus, S. M., Meyer, T. E., & Christman, S. A. (2008) · The American Journal of Cardiology · doi:10.1016/j.amjcard.2008.03.080 · Cited by 46
Understanding Atrial Fibrillation: The Signal Processing Contribution, Part II
Mainardi, L., Sörnmo, L., & Cerutti, S. (2008) · Synthesis lectures on biomedical engineering · doi:10.2200/s00153ed1v01y200809bme025 · Cited by 47
High Rate Atrial Tachyarrhythmia Detections in Implantable Pulse Generators: Low Incidence of False‐Positive Detections
Fitts, S. M., Hill, M., Mehra, R., et al. (2000) · Pacing and Clinical Electrophysiology · doi:10.1111/j.1540-8159.2000.tb00905.x · Cited by 46
Silent Atrial Fibrillation—Another Pandora's Box
Savelieva, I., & Camm, A. J. (2000) · Pacing and Clinical Electrophysiology · doi:10.1111/j.1540-8159.2000.tb00794.x · Cited by 46
Cardiac and Pulmonary Investigations in Bethlem Myopathy
van der Kooi, A. J., de Voogt, W. G., Bertini, E., et al. (2006) · Archives of Neurology · doi:10.1001/archneur.63.11.1617 · Cited by 46
Long-Term Prognosis of Patients With Paroxysmal Atrial Fibrillation Depends on Their Response to Antiarrhythmic Therapy
Komatsu, T., Nakamura, S., Сузукі, О., Horiuchi, D., Yomogida, K., & Okumura, K. (2004) · Circulation Journal · doi:10.1253/circj.68.729 · Cited by 42
Atrial Fibrillation Burden Estimates Derived from Intermittent Rhythm Monitoring are Unreliable Estimates of the True Atrial Fibrillation Burden
Charitos, E. I., Ziegler, P., Stierle, U., Robinson, D., GRAF, B., Sievers, H., & Hanke, T. (2014) · Pacing and Clinical Electrophysiology · doi:10.1111/pace.12389 · Cited by 45
Excessive Supraventricular Ectopic Activity Is Indicative of Paroxysmal Atrial Fibrillation in Patients with Cerebral Ischemia
Weber-Krüger, M., Gröschel, K., Mende, M., Seegers, J., Lahno, R., Haase, B., Niehaus, C., Edelmann, F., Hasenfuss, G. P., Wachter, R., et al. (2013) · PLoS ONE · doi:10.1371/journal.pone.0067602 · Cited by 43
“Bursts of paroxysmal atrial fibrillation (PAF) can be short, they often occur in clusters [1] and are asymptomatic in over 50% of the cases [2].”
Background
Optimal Duration of Monitoring for Atrial Fibrillation in Cryptogenic Stroke: A Nonsystematic Review
Hariri, E. H., Hachem, A. A., Sarkis, G., & Nasr, S. (2016) · BioMed Research International · doi:10.1155/2016/5704963 · Cited by 47
“Overall, we thus conclude that increasing the monitoring duration for AF after a cryptogenic stroke to at least 72 hours will indeed enhance the detection rates, but the cost-effectiveness of thismonitoring strategy compared to longer monitoring durations is yet to be established.”
Background
The incidence of asymptomatic paroxysmal atrial fibrillation in patients treated with propranolol or propafenone
Wolk, R. A., Kułakowski, P., Karczmarewicz, S., Karpiński, G., Makowska, E., Czepiel, A., & Ceremuzyński, L. (1996) · International Journal of Cardiology · doi:10.1016/0167-5273(96)02631-9 · Cited by 43
Prediction of Atrial Fibrillation in Patients with an Implantable Cardioverter-Defibrillator and Heart Failure
Bertini, M., Borleffs, C. J. W., Delgado, V., Ng, A. C. T., Piers, S. R. D., Shanks, M., Antoni, M. L., Biffi, M., Boriani, G., Schalij, M. J., et al. (2010) · European Journal of Heart Failure · doi:10.1093/eurjhf/hfq126 · Cited by 42
“Device-based diagnostics derived from pacemaker or implantable cardioverter-defibrillator (ICD) interrogation provide an accurate method for detecting asymptomatic AF episodes.(9,10) Accordingly, in order to detect all AF episodes including the asymptomatic AF episodes, a cohort of heart failure patients who had under…”
Method
Paroxysmal atrial fibrillation with silent episodes: Intermittent versus continuous monitoring
Doliwa, P. S., Rosenqvist, M., & Frykman, V. (2012) · Scandinavian Cardiovascular Journal · doi:10.3109/14017431.2012.661873 · Cited by 42
Evaluation of the C2HEST Risk Score as a Possible Opportunistic Screening Tool for Incident Atrial Fibrillation in a Healthy Population (From a Nationwide Danish Cohort Study)
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
Absence of Correlation Between Symptoms and Rhythm in “Symptomatic” Atrial Fibrillation
Mehall, J. R., Kohut, R. M., Schneeberger, E. W., Merrill, W. H., & Wolf, R. K. (2007) · The Annals of Thoracic Surgery · doi:10.1016/j.athoracsur.2007.02.084 · Cited by 40
Prediction of the Recurrence of Atrial Fibrillation After Successful Cardioversion with P Wave Signal‐Averaged ECG
Budeus, M., Hennersdorf, M., Perings, C., et al. (2005) · Annals of Noninvasive Electrocardiology · doi:10.1111/j.1542-474x.2005.00059.x · Cited by 41
Asymptomatic recurrences of atrial fibrillation after pulmonary vein isolation
Neumann, T., Erdoğan, A., Dill, T., Greiß, H., Berkowitsch, A., Sperzel, J., Kuniss, M., Kurzidim, K. W., Hamm, C. W., & Pitschner, H.-F. (2006) · EP Europace · doi:10.1093/europace/eul056 · Cited by 38
Anticoagulation in management of atrial fibrillation
Ezekowitz, M. D., & Netrebko, P. I. (2003) · Current Opinion in Cardiology · doi:10.1097/00001573-200301000-00004 · Cited by 41
Atrial Fibrillation
Al‐Khatib, S. M. (2023) · Annals of Internal Medicine · doi:10.7326/aitc202307180 · Cited by 41
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
Incidence of Atrial Arrhythmias Detected by Permanent Pacemakers (PPM) Post‐Pulmonary Vein Antrum Isolation (PVAI) for Atrial Fibrillation (AF): Correlation with Symptomatic Recurrence
Verma, A., Minor, S., Kılıçaslan, F., Patel, D., Hao, S. C., Beheiry, S., Lakkireddy, D., Elayi, S. C., Cummings, J. E., Martin, D. O., et al. (2007) · Journal of Cardiovascular Electrophysiology · doi:10.1111/j.1540-8167.2007.00789.x · Cited by 40
Electrophysiological abnormalities of the atrial muscle in patients with paroxysmal atrial fibrillation associated with hyperthyroidism
Komiya, N., Isomoto, S., Nakao, K., et al. (2002) · Clinical Endocrinology · doi:10.1046/j.0300-0664.2001.01459.x · Cited by 39
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
“The aim of the present study is to investigate whether severity of atrial fibrillation (AF) symptoms impacts prognosis in permanent AF. methods.”
BackgroundInfluential
Association Between Panic Disorder and Risk of Atrial Fibrillation
Cheng, Y.-F., Leu, H., Su, C., Huang, C., Chiang, C.-H., Huang, P., Chung, C., Lin, S., Chen, J., & Chan, W. (2012) · Psychosomatic Medicine · doi:10.1097/psy.0b013e318273393a · Cited by 39
“Aswe know, up to 90% of episodes for people with paroxysmal AF are asymptomatic (30), and paroxysmal AF may not be identified by practitioners if patients are not aware of having paroxysmal AF attacks.”
Background
Anticoagulation Management Pre- and Post Atrial Fibrillation Ablation: A Survey of Canadian Centres
Mardigyan, V., Verma, A., Birnie, D. H., Guerra, P. G., Redfearn, D., Becker, G., Champagne, J., Sapp, J. L., Gula, L. J., Parkash, R., et al. (2012) · Canadian Journal of Cardiology · doi:10.1016/j.cjca.2012.04.013 · Cited by 38
“Even among patients with documented symptomatic AF, asymptomatic recurrences are 12 times more common than symptomatic episodes.(10) During the past decade, radiofrequency catheter ablation of AF has been used with increasing frequency in the management of symptomatic patients.”
Background
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
A preliminary assessment of the effects of ATI-2042 in subjects with paroxysmal atrial fibrillation using implanted pacemaker methodology
Arya, A., Silberbauer, J., Teichman, S. L., Milner, P., Sulke, N., & Camm, A. J. (2008) · EP Europace · doi:10.1093/europace/eun384 · Cited by 37
Relationship of Atrial Fibrillation and N Terminal Pro Brain Natriuretic Peptide in Heart Failure Patients
Nasab, E. M., Khosroshahi, V. T., & Athari, S. S. (2023) · ESC Heart Failure · doi:10.1002/ehf2.14542 · Cited by 38
“16,17 Symptoms can be caused by increased ventricular rate, irregular ventricular rate, or loss of atrial contribution to cardiac output.”
Background
The changing epidemiology and natural history of nonvalvular atrial fibrillation: clinical implications.
Gersh, B. J., Tsang, T. S. M., & Seward, J. B. (2004) · PubMed Central · 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
Management of Atrial Fibrillation — Radical Reform or Modest Modification?
Falk, R. H. (2002) · New England Journal of Medicine · doi:10.1056/nejme020137 · 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
“A clear limitation in correlating the risk of stroke with this simplistic clinical scheme of classifying AF – and relating it to arrhythmia burden – is that a significant proportion of patients remain asymptomatic during recurrences of AF [63].”
Background

Authors: Page, R. L., Wilkinson, W. E., Clair, W. K., McCarthy, E. A., & Pritchett, E. L.
Affiliations: Duke Medical Center (US)
ORCID: Page, R L
Wilkinson, W E
Clair, W K
Venue: Circulation
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 1994-01
Volume: 89
Issue: 1
Pages: 224-227
ISSN: 0009-7322 (ISSN-L)
1524-4539
DOI: 10.1161/01.cir.89.1.224
OpenAlex: W2010550566
Cited by: 627
References: 0
Citations by year: 2026: 3 · 2025: 5 · 2024: 12 · 2023: 15 · 2022: 16 · 2021: 19 · 2020: 11 · 2019: 9 · 2018: 20 · 2017: 19 · 2016: 21 · 2015: 25 · 2014: 29 · 2013: 25 · 2012: 31
FWCI: 7.88
Type: journal article
Language: en
Open access: closed
Locations: Circulation (publishedVersion)
PubMed (publishedVersion)
Funders: National Institutes of Health (1r01hl040392-01a1)
National Heart, Lung, and Blood Institute (R01-HL-40392)
National Center for Research Resources (MO 1 RR-30)
Topics: Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Atrial Fibrillation Management and Outcomes
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Arrhythmias and Treatments
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac electrophysiology and arrhythmias
Keywords: paroxysmal atrial fibrillation, paroxysmal supraventricular tachycardia, asymptomatic arrhythmia, arrhythmia frequency, Holter monitoring, stroke risk, antiarrhythmic drugs, calcium channel blockers, beta-blockers
MeSH terms: Atrial Fibrillation, Female, Humans, Male, Middle Aged, Stochastic Processes, Tachycardia, Paroxysmal, Tachycardia, Supraventricular, Time Factors, Electrocardiography, Ambulatory, Confidence Intervals

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

Asymptomatic arrhythmias in patients with symptomatic paroxysmal atrial fibrillation and paroxysmal supraventricular tachycardia

Abstract

Overview

Integrity signals

Verification

Claims the paper makes

Claims other papers make about this one

Citations

Cited by

Related

Metadata

Record

About these checks