University Hospital St Josef-Hospital Bochum, Cardiology and Rhythmology, Ruhr University Bochum, Gudrunstraße 56, 44791, Bochum, Germany.
Clin Res Cardiol. 2022 Sep;111(9):994-1009. doi: 10.1007/s00392-022-02000-7. Epub 2022 Mar 15.
Long-term and continuous ECG monitoring using cardiac implantable electronic devices and insertable cardiac monitors has improved the capability of detecting subclinical atrial fibrillation (AF) and atrial high-rate episodes. Previous studies demonstrated a high prevalence (more than 20%) in patients with cardiac implantable electronic devices or insertable cardiac monitors. Subclinical AF and atrial high-rate episodes are often suspected as the cause of prior or potential future ischemic stroke. However, the clinical significance is still uncertain, and the evidence is limited. This review aims to present and discuss the current evidence on the clinical impact of subclinical AF and atrial high-rate episodes. It focuses particularly on the association between the duration of the episodes and major clinical outcomes like thromboembolic events. As subclinical AF and atrial high-rate episodes are presumed to be associated with ischemic strokes, detection will be particularly important in patients with cryptogenic stroke and in high-risk patients for thromboembolism. In this context, it is also interesting whether there is a temporal relationship between the detection of subclinical AF and atrial high-rate episodes and the occurrence of thromboembolic events. In addition, the review will examine the question whether there is a need for a therapy with oral anticoagulation.
使用心脏植入式电子设备和可植入心脏监测器进行长期和连续的心电图监测提高了检测亚临床心房颤动（AF）和心房高心率事件的能力。先前的研究表明，在心脏植入式电子设备或可植入心脏监测器的患者中，其患病率较高（超过 20%）。亚临床 AF 和心房高心率事件常被怀疑为先前或潜在未来缺血性卒中的原因。然而，其临床意义仍不确定，证据有限。本综述旨在介绍和讨论亚临床 AF 和心房高心率事件的临床影响的现有证据。它特别关注事件持续时间与主要临床结局（如血栓栓塞事件）之间的关联。由于亚临床 AF 和心房高心率事件被认为与缺血性卒中有关联，因此在隐源性卒中和血栓栓塞高风险患者中，检测将尤为重要。在这种情况下，检测亚临床 AF 和心房高心率事件与血栓栓塞事件发生之间是否存在时间关系也是一个有趣的问题。此外，该综述将探讨是否需要进行口服抗凝治疗。
