F Russell Quinn1, David Gladstone. 1. aLibin Cardiovascular Institute of Alberta, Calgary, Alberta bSunnybrook Health Sciences Centre, Division of Neurology, Department of Medicine, University of Toronto, and University of Toronto Stroke Program, Toronto, Ontario, Canada.
Abstract
PURPOSE OF REVIEW: Recent years have seen significant advances in knowledge about the prevalence of 'silent' atrial fibrillation and the morbidity associated with this condition. Data are emerging on improved strategies for screening, and new technologies for detecting atrial fibrillation are becoming available, making a review of this field timely. RECENT FINDINGS: Studies suggest that, when screening is performed, undiagnosed atrial fibrillation is present in around 1% of the screened population, rising to 1.4% for those aged at least 65 years. The prevalence of silent atrial fibrillation is even higher in patients with additional risk factors (e.g. those aged 75 years, patients with heart failure). Prolonged monitoring of patients with hypertension and an implanted cardiac device showed subclinical atrial arrhythmias in at least 10% and these patients had a 2.5-fold increased risk of stroke or systemic embolism. The feasibility of screening for silent atrial fibrillation has been demonstrated in a number of populations and many new technologies for atrial fibrillation detection exist, which could improve the efficiency and cost-effectiveness of this process. SUMMARY: Increased attention is being directed towards screening for silent atrial fibrillation and our 'toolbox' for detecting it is expanding. Whether this will translate into improved outcomes for patients remains to be proven.
PURPOSE OF REVIEW: Recent years have seen significant advances in knowledge about the prevalence of 'silent' atrial fibrillation and the morbidity associated with this condition. Data are emerging on improved strategies for screening, and new technologies for detecting atrial fibrillation are becoming available, making a review of this field timely. RECENT FINDINGS: Studies suggest that, when screening is performed, undiagnosed atrial fibrillation is present in around 1% of the screened population, rising to 1.4% for those aged at least 65 years. The prevalence of silent atrial fibrillation is even higher in patients with additional risk factors (e.g. those aged 75 years, patients with heart failure). Prolonged monitoring of patients with hypertension and an implanted cardiac device showed subclinical atrial arrhythmias in at least 10% and these patients had a 2.5-fold increased risk of stroke or systemic embolism. The feasibility of screening for silent atrial fibrillation has been demonstrated in a number of populations and many new technologies for atrial fibrillation detection exist, which could improve the efficiency and cost-effectiveness of this process. SUMMARY: Increased attention is being directed towards screening for silent atrial fibrillation and our 'toolbox' for detecting it is expanding. Whether this will translate into improved outcomes for patients remains to be proven.
Authors: F Russell Quinn; David J Gladstone; Noah M Ivers; Roopinder K Sandhu; Lisa Dolovich; Andrea Ling; Juliet Nakamya; Chinthanie Ramasundarahettige; Paul A Frydrych; Sam Henein; Ken Ng; Valerie Congdon; Richard V Birtwhistle; Richard Ward; Jeffrey S Healey Journal: CMAJ Open Date: 2018-08-02
Authors: Steven B Uittenbogaart; Nicole Verbiest-van Gurp; Petra M G Erkens; Wim A M Lucassen; J André Knottnerus; Bjorn Winkens; Henk C P M van Weert; Henri E J H Stoffers Journal: Trials Date: 2015-10-23 Impact factor: 2.279
Authors: Thomas M Helms; Giang Duong; Bettina Zippel-Schultz; Roland Richard Tilz; Karl-Heinz Kuck; Christoph A Karle Journal: EPMA J Date: 2014-09-02 Impact factor: 6.543