Cited by 676Atrial Fibrillation Management and OutcomesCardiac pacing and defibrillation studiesCardiovascular and Diving-Related Complications

Temporal relationship between subclinical atrial fibrillation and embolic events

Open access
Brambatti, Michela, Connolly, Stuart J., Gold, Michael R., Morillo, Carlos A., Capucci, Alessandro, Muto, Carmine, Lau, Chu P., Van Gelder, Isabelle C. +9 more·2014·Circulation

Abstract

BACKGROUND: Among patients with implantable pacemakers and defibrillators, subclinical atrial fibrillation (SCAF) is associated with an increased risk of stroke; however, there is limited understanding of their temporal relationship. METHODS AND RESULTS: The Asymptomatic Atrial Fibrillation and Stroke Evaluation in Pacemaker Patients and the Atrial Fibrillation Reduction Atrial Pacing Trial (ASSERT) enrolled 2580 pacemaker and defibrillator patients aged ≥65 years with a history of hypertension but without a history of atrial fibrillation. Pacemakers and implantable cardioverter-defibrillators precisely logged the time and duration of all episodes of SCAF and recorded electrograms that were adjudicated by experts. We examined the temporal relationship between SCAF >6 minutes in duration and stroke or systemic embolism. Of 51 patients who experienced stroke or systemic embolism during follow-up, 26 (51%) had SCAF. In 18 patients (35%), SCAF was detected before stroke or systemic embolism. However, only 4 patients (8%) had SCAF detected within 30 days before stroke or systemic embolism, and only 1 of these 4 patients was experiencing SCAF at the time of the stroke. In the 14 patients with SCAF detected >30 days before stroke or systemic embolism, the most recent episode occurred at a median interval of 339 days (25th to 75th percentile, 211-619) earlier. Eight patients (16%) had SCAF detected only after their stroke, despite continuous monitoring for a median duration of 228 days (25th to 75th percentile, 202-719) before their event. CONCLUSIONS: Although SCAF is associated with an increased risk of stroke and embolism, very few patients had SCAF in the month before their event. CLINICAL TRIAL REGISTRATION URL: http://www.clinicaltrials.gov. Unique identifier: NCT00256152.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1161/circulationaha.113.007825

Cites

31 of 31 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

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?

  • Supraventricular tachycardia is associated with the development of AF and an increased risk of stroke even in patients without AF.

    “The detection of supraventricular tachycardia (SVT) may be important as well as it is associated with the development of AF and an increased risk of stroke even in patients without AF (4–6).”

    From Diagnostic Yield of Extended Cardiac Patch Monitoring in Patients with Stroke or TIA (2015) · cites this paper as [5]

    The Abstract (page not provided) reports that subclinical atrial fibrillation (SCAF) can progress to clinically documented AF and is associated with increased stroke or systemic-embolism risk in patients without a prior history of AF. The Methods identify the monitored episodes as SCAF, not supraventricular tachycardia (SVT). The source therefore does not establish the claim for SVT generally or for patients without AF, as opposed to patients without previously diagnosed AF. (LLM, conf=0.87)

    Experimental — accuracy not yet measured
  • Strokes often occur without AHRE detected within 30 days before the event.

    “Strokes often occur without AHRE detected within 30 days before the event.143-147”

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

Flagged first, then by citations

Research works printed but not linked: 2

  1. Kannel WB, Wolf PA, Benjamin EJ, Levy D. Prevalence, incidence, prog- nosis, and predisposing conditions for atrial fibrillation: population-based estimates. Am J Cardiol. 1998;82:2N-9N.
  2. Anderson K, Benzauquen BS. Do patients with pacemaker-detected atrial fibrillation receive appropriate anticoagulation? Europace. 2011;13:519.

Cited by

Sorted by citations

Authors
Brambatti, M., Connolly, S. J., Gold, M. R., Morillo, C. A., Capucci, A., Muto, C., Lau, C. P., Van Gelder, I. C., Hohnloser, S. H., Carlson, M., Fain, E., Nakamya, J., Mairesse, G. H., Halytska, M., Deng, W. Q., Israel, C. W., & Healey, J. S.
Affiliations
  • Goethe University Frankfurt (DE)
  • From the Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada (M.B., S.J.C., C.A.M., J.N., M.H., W.Q.D., J.S.H.); Clinica di Cardiologia, Università Politecnica delle Marche, Ancona, Italy (M.B., A.C.); Medical University of South Carolina, Charleston (M.R.G.); Cardiology Department, Loreto Mare, Napoli, Italy (C.M.); Queen Mary Hospital, Department of Medicine, University of Hong Kong, Hong Kong, China (C.P.L.); University of Groningen, University Medical Center...
Venue
Circulation
Published
2014-05-27
Volume
129
Issue
21
Pages
2094-2099
ISSN
  • 0009-7322 (ISSN-L)
  • 1524-4539
OpenAlex
W2024497977
Cited by
676
References
31
Citations by year
2026: 21 · 2025: 35 · 2024: 52 · 2023: 66 · 2022: 62 · 2021: 67 · 2020: 55 · 2019: 63 · 2018: 57 · 2017: 66 · 2016: 58 · 2015: 57 · 2014: 15 · 2012: 1
FWCI
44.81
Type
journal article
Language
en
Licence
other-oa
Locations
  • Circulation (publishedVersion)
  • PubMed (publishedVersion)
  • Università Politecnica delle Marche (Università Politecnica delle Marche) (submittedVersion)
  • University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion)
  • INFM-OAR (INFN Catania) (submittedVersion, other-oa)
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, stroke, systemic embolism, implantable cardioverter-defibrillator, cardiac pacemaker, temporal relations, asymptomatic atrial fibrillation, hypertension
MeSH terms
Aged, Aged, 80 and over, Atrial Fibrillation, Embolism, Female, Follow-Up Studies, Humans, Male, Pacemaker, Artificial, Prospective Studies, Risk Factors, Time Factors, Stroke

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