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Asymptomatic arrhythmias in patients with symptomatic paroxysmal atrial fibrillation and paroxysmal supraventricular tachycardia
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.
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“Paroxysmal AF is often asymptomatic whilst paroxysmal SVT is usually symptomatic, 13”
From European Heart Rhythm Association (EHRA) consensus document on the management of supraventricular arrhythmias, endorsed by Heart Rhythm Society (HRS), Asia-Pacific Heart Rhythm Society (APHRS), and Sociedad Latinoamericana de Estimulacion Cardiaca y Electrofisiologia (SOLAECE) (2017) · cites this paper as [13]
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Tsai, C., Chiou, W., Huang, C., Lin, P., Lee, Y., Lin, S.-I., & Liao, F. (2022) · SSRN Electronic Journal · doi:10.2139/ssrn.4185915
How is Sinus Rhythm Maintained in Paroxysmal Atrial Fibrillation?
Waktare, J. E. P., & Camm, A. J. (1998) · The Journal of the Royal College of Physicians of Edinburgh · doi:10.1177/147827159802800408
Introduction to Atrial Fibrillation
Bollmann, A., & Lombardi, F. (2008) · Synthesis lectures on biomedical engineering · doi:10.1007/978-3-031-01633-2_1
EXPLORING THE POTENTIAL OF MACHINE LEARNING FOR DIAGNOSIS OF ATRIAL FIBRILLATION
(2023) · International Research Journal of Modernization in Engineering Technology and Science · doi:10.56726/irjmets32717
Oral Anticoagulation in Patients With Atrial High-Rate Episodes: Focus on Clinical Implications
Dimou, S., Mystakidi, V. C., Chiotis, S., et al. (2023) · Cureus · doi:10.7759/cureus.46686
Tearwattanarattikal, T., & Lek-uthai, A. (2023) · Biomedical Engineering International Conference · doi:10.1109/bmeicon60347.2023.10322038
“ECG recordings were divided into 30-second ECG segments referring to arrhythmia duration criterion from [7], [8].”
MethodExploring the association between atrial fibrillation and celiac disease: a comprehensive review
Subedi, R., Soulat, A., Butt, S. R., Mohan, A., Butt, M. D., Arwani, S., Ahmed, G., Majumder, K., Lal, P. M., Kumar, V., et al. (2024) · Annals of Medicine and Surgery · doi:10.1097/ms9.0000000000002259
“Asymptomatic individuals are diagnosed on routine investigations for pacemaker regulation [67] .”
Symptomatic or asymptomatic atrial arrhythmias: Should that change management?
Joglar, J. A., & Rosenblatt, A. (2024) · Heart Rhythm · doi:10.1016/j.hrthm.2024.06.022
Unlocking the mysteries of cryptogenic stroke: the role of long-term cardiac rhythm monitoring
Papakonstantinou, P. Ε. (2024) · Future Cardiology · doi:10.1080/14796678.2024.2377922
Diagnosis of Narrow QRS Tachycardia
Yang, P. (2024) · Korean Journal of Medicine · doi:10.3904/kjm.2024.99.4.206
Palpitations: A Practical Approach
Vargas, D. A. R., Jaramillo-Álvarez, J. C., & Gándara-Ricardo, J. A. (2025) · Cureus · doi:10.7759/cureus.97748
“An irregular pulse suggests atrial fibrillation or premature ventricular contractions with a positive predictive value of 91% for finding a significant arrhythmia on 24-hour ECG monitoring [7].”
Chao, T., Lau, C., Choi, E., Ching, C., Chan, N., Hung, C., Joung, B., Krittayaphong, R., Tse, H., & Lip, G. Y. H. (2025) · The Lancet Regional Health - Western Pacific · doi:10.1016/j.lanwpc.2025.101770 · Cited by 2
“20 In patients who have undergone catheter ablation, previously symptomatic paroxysmal AF is more likely to become asymptomatic.”
Nichtpharmakologische Therapie des Vorhofflimmerns
Fx, R., Hintringer, F., & Pachinger, O. M. (2001) · Journal für Kardiologie (Krause & Pachernegg GmbH)
Epidemiologie, klinischer Verlauf und Prognose
Schuchert, A., & Meinertz, T. (2000) · Steinkopff eBooks · doi:10.1007/978-3-662-13383-5_2
Jubayel, M., Joya, J. G., Hasan, R., Anik, M. A. R., Islam, M. M., & Islam, M. J. (2025) · International Conference on Computer and Information Technology (ICCIT) · doi:10.1109/iccit68739.2025.11490392
“Because paroxysmal and persistent forms of the irregular electrical activity of the atria differ greatly, manual interpretation of ECG signals is quite time-consuming and requires the expertise of skilled cardiologists [11].”
Singh, G., Saraswat, S., Rajesh, A., et al. (2025) · doi:10.1109/iccetm66557.2025.11557641
Al-Ali, M. H., AL-Myahi, M., AL-Obaidi, F. R., & Kadhim, M. A. (2026) · Ukrainian Journal of Cardiology · doi:10.31928/2664-4479-2026.3.3945
Music-Inspired MK545Pat for AF/PAF/Non-AF Classification Using ECG Signals
Gulensoy, I. E., Tuncer, I., Kıvrak, T., Göktaş, Ö. F., Bayğın, M., Barua, P. D., Doğan, Ş., Kobat, M. A., & Tuncer, T. (2026) · Bioengineering · doi:10.3390/bioengineering13091016
“Episodes may be brief, intermittent, and asymptomatic, making them difficult to capture on intermittent ECG recordings [9,10].”
Кажина, М. В., Vasil'ev, V. S., & Karpovich, N. N. (2003) · PubMed
Langzeitergebnisse der Katheterablation von Vorhofflimmern
Bode, K., Rolf, S., Sommer, P., Richter, S., & Hindricks, G. (2014) · Herzschrittmachertherapie + Elektrophysiologie · doi:10.1007/s00399-014-0328-4
Metadata
- Authors
- Page, R. L., Wilkinson, W. E., Clair, W. K., McCarthy, E. A., & Pritchett, E. L.
- Affiliations
- Duke Medical Center (US)
- Venue
- Circulation
- Published
- 1994-01
- Volume
- 89
- Issue
- 1
- Pages
- 224-227
- ISSN
- 0009-7322 (ISSN-L)
- 1524-4539
- 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
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