Alhwarat Buthainah, Darwish Omar, Ghanta Sai Nikhila, Rana Aakash, Gautam Nitesh, Al'Aref Subhi J, Devabhaktuni Subodh
Department of Internal Medicine, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA.
Division of Cardiology, Department of Internal Medicine, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA.
J Clin Med. 2025 Jul 23;14(15):5222. doi: 10.3390/jcm14155222.
Subclinical atrial fibrillation (SCAF) episodes are frequently detected in patients with cardiac implantable electronic devices (CIEDs). These asymptomatic arrhythmias are increasingly recognized as potential harbingers of clinical atrial fibrillation and thromboembolic events. However, the management of SCAF-particularly regarding the use of oral anticoagulation (OAC)-remains controversial. This literature review (Medline, Scopus, Goggle scholar, Embase) focuses on using current literature and clinical studies to guide decision-making regarding anticoagulation therapy and other treatment options that can limit complications for patients with SCAF. The decision to initiate anticoagulation in patients with atrial high-rate episodes (AHREs) should be individualized, balancing stroke risk against bleeding potential. Ongoing research and post hoc analyses will further clarify which subgroups may benefit most from therapy, informing future guideline recommendations.
在植入心脏电子设备（CIED）的患者中经常检测到亚临床房颤（SCAF）发作。这些无症状性心律失常越来越被认为是临床房颤和血栓栓塞事件的潜在先兆。然而，SCAF的管理——尤其是关于口服抗凝药（OAC）的使用——仍然存在争议。这篇文献综述（Medline、Scopus、谷歌学术、Embase）侧重于利用当前文献和临床研究来指导关于抗凝治疗以及其他可减少SCAF患者并发症的治疗选择的决策。对于有房性快速性心律失常（AHREs）的患者，启动抗凝治疗的决定应个体化，权衡卒中风险与出血可能性。正在进行的研究和事后分析将进一步阐明哪些亚组可能从治疗中获益最大，为未来的指南推荐提供依据。
