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Subclinical and Device-Detected Atrial Fibrillation: Pondering the Knowledge Gap: A Scientific Statement From the American Heart Association
Open accessAbstract
The widespread use of cardiac implantable electronic devices and wearable monitors has led to the detection of subclinical atrial fibrillation in a substantial proportion of patients. There is evidence that these asymptomatic arrhythmias are associated with increased risk of stroke. Thus, detection of subclinical atrial fibrillation may offer an opportunity to reduce stroke risk by initiating anticoagulation. However, it is unknown whether long-term anticoagulation is warranted and in what populations. This scientific statement explores the existing data on the prevalence, clinical significance, and management of subclinical atrial fibrillation and identifies current gaps in knowledge and areas of controversy and consensus.
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“Unlike patient decision aids (which are used by the patient in preparation prior to the clinical encounter), conversation aids are designed for use within the clinical encounter to guide the patient and clinician through the shared decision-making process [28, 30].”
From Explainability for artificial intelligence in healthcare: a multidisciplinary perspective (2020) · cites this paper as [30]
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Metadata
- Authors
- Noseworthy, P. A., Kaufman, E. S., Chen, L. Y., Chung, M. K., Elkind, M. S. V., Joglar, J. A., Leal, M. A., McCabe, P. J., Pokorney, S. D., Yao, X., & On behalf of the American Heart Association Council on Clinical Cardiology Electrocardiography and Arrhythmias Committee; Council on Arteriosclerosis, T. A. V. B. C. O. C. A. S. N. A. S. C.
- ORCID
- Venue
- Circulation
- Published
- 2019-12-17
- Volume
- 140
- Issue
- 25
- Pages
- e944-e963
- ISSN
- 0009-7322 (ISSN-L)
- 1524-4539
- PMC
- PMC8438789
- OpenAlex
- W2982905111
- Cited by
- 171
- References
- 55
- Citations by year
- 2026: 16 · 2025: 23 · 2024: 27 · 2023: 34 · 2022: 34 · 2021: 20 · 2020: 15 · 2019: 2
- FWCI
- 3.22
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Locations
- Circulation (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Heart, Lung, and Blood Institute (R01HL111314)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Atrial Fibrillation Management and Outcomes
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac pacing and defibrillation studies
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Cardiovascular and Diving-Related Complications
- Keywords
- subclinical atrial fibrillation, device-detected atrial fibrillation, cardiac implantable electronic devices, wearable monitors, stroke risk, anticoagulation, long-term anticoagulation, asymptomatic arrhythmia, prevalence, clinical management
- MeSH terms
- Wearable Electronic Devices, American Heart Association, Atrial Fibrillation, Humans, Health Knowledge, Attitudes, Practice, Pacemaker, Artificial, Risk Factors, United States, Defibrillators, Implantable
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