Atrial high-rate episodes and stroke prevention

A John Camm; Emmanuel Simantirakis; Andreas Goette; Gregory Y H Lip; Panos Vardas; Gregory Chlouverakis; Hans-Christoph Diener; Paulus Kirchhof; Melanie Calvert

doi:10.1093/europace/euw279

Atrial high-rate episodes and stroke prevention

A John Camm, Emmanuel Simantirakis, Andreas Goette, Gregory Y H Lip, Panos Vardas, Gregory Chlouverakis, Hans-Christoph Diener, Paulus Kirchhof, Melanie Calvert

Research output: Contribution to journal › Article › peer-review

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Abstract

While the benefit of oral anticoagulants (OACs) for stroke prevention in patients with atrial fibrillation (AF) is well established, it is not known whether oral anticoagulation is indicated in patients with atrial high rate episodes (AHRE) recorded on a cardiac implantable electronic device (CIED), sometimes also called subclinical AF (SCAF), and lasting for at least 6 minutes in the absence of clinically diagnosed AF. Clinical evidence has shown that short episodes of rapid atrial tachycarrhythmias are often detected in patients presenting with stroke and TIA. Patients with AHRE have a higher likelihood of suffering from subsequent strokes, but their stroke rate seems lower than in patients with diagnosed AF, and not all AHRE episodes correspond to AF. The prognostic and pathological significance of AHRE is not yet fully understood. Clinical
trials of oral anticoagulant therapy are being conducted to determine whether
therapeutic intervention would be beneficial to patients experiencing AHRE in terms of reducing the risk of stroke.

Original language	English
Pages (from-to)	169-179
Number of pages	11
Journal	Europace
Volume	19
Issue number	2
Early online date	4 Oct 2016
DOIs	https://doi.org/10.1093/europace/euw279
Publication status	Published - 1 Feb 2017

Keywords

atrial fibrillation
stroke
thromboembolic risk
atrial high rate episodes
subclinical atrial fibrillation
paroxysmal atrial fibrillation
anticoagulation
cardiovascular implantable electronic devices
CIEDs

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Cite this

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title = "Atrial high-rate episodes and stroke prevention",

abstract = "While the benefit of oral anticoagulants (OACs) for stroke prevention in patients with atrial fibrillation (AF) is well established, it is not known whether oral anticoagulation is indicated in patients with atrial high rate episodes (AHRE) recorded on a cardiac implantable electronic device (CIED), sometimes also called subclinical AF (SCAF), and lasting for at least 6 minutes in the absence of clinically diagnosed AF. Clinical evidence has shown that short episodes of rapid atrial tachycarrhythmias are often detected in patients presenting with stroke and TIA. Patients with AHRE have a higher likelihood of suffering from subsequent strokes, but their stroke rate seems lower than in patients with diagnosed AF, and not all AHRE episodes correspond to AF. The prognostic and pathological significance of AHRE is not yet fully understood. Clinicaltrials of oral anticoagulant therapy are being conducted to determine whethertherapeutic intervention would be beneficial to patients experiencing AHRE in terms of reducing the risk of stroke.",

keywords = "atrial fibrillation, stroke, thromboembolic risk, atrial high rate episodes, subclinical atrial fibrillation, paroxysmal atrial fibrillation, anticoagulation, cardiovascular implantable electronic devices, CIEDs",

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AU - Camm, A John

AU - Simantirakis, Emmanuel

AU - Goette, Andreas

AU - Lip, Gregory Y H

AU - Vardas, Panos

AU - Chlouverakis, Gregory

AU - Diener, Hans-Christoph

AU - Kirchhof, Paulus

AU - Calvert, Melanie

PY - 2017/2/1

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N2 - While the benefit of oral anticoagulants (OACs) for stroke prevention in patients with atrial fibrillation (AF) is well established, it is not known whether oral anticoagulation is indicated in patients with atrial high rate episodes (AHRE) recorded on a cardiac implantable electronic device (CIED), sometimes also called subclinical AF (SCAF), and lasting for at least 6 minutes in the absence of clinically diagnosed AF. Clinical evidence has shown that short episodes of rapid atrial tachycarrhythmias are often detected in patients presenting with stroke and TIA. Patients with AHRE have a higher likelihood of suffering from subsequent strokes, but their stroke rate seems lower than in patients with diagnosed AF, and not all AHRE episodes correspond to AF. The prognostic and pathological significance of AHRE is not yet fully understood. Clinicaltrials of oral anticoagulant therapy are being conducted to determine whethertherapeutic intervention would be beneficial to patients experiencing AHRE in terms of reducing the risk of stroke.

AB - While the benefit of oral anticoagulants (OACs) for stroke prevention in patients with atrial fibrillation (AF) is well established, it is not known whether oral anticoagulation is indicated in patients with atrial high rate episodes (AHRE) recorded on a cardiac implantable electronic device (CIED), sometimes also called subclinical AF (SCAF), and lasting for at least 6 minutes in the absence of clinically diagnosed AF. Clinical evidence has shown that short episodes of rapid atrial tachycarrhythmias are often detected in patients presenting with stroke and TIA. Patients with AHRE have a higher likelihood of suffering from subsequent strokes, but their stroke rate seems lower than in patients with diagnosed AF, and not all AHRE episodes correspond to AF. The prognostic and pathological significance of AHRE is not yet fully understood. Clinicaltrials of oral anticoagulant therapy are being conducted to determine whethertherapeutic intervention would be beneficial to patients experiencing AHRE in terms of reducing the risk of stroke.

KW - atrial fibrillation

KW - stroke

KW - thromboembolic risk

KW - atrial high rate episodes

KW - subclinical atrial fibrillation

KW - paroxysmal atrial fibrillation

KW - anticoagulation

KW - cardiovascular implantable electronic devices

KW - CIEDs

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SP - 169

EP - 179

JO - Europace

JF - Europace

IS - 2

ER -

Atrial high-rate episodes and stroke prevention

Abstract

Keywords

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