“We need not over-react to brief episodes of AF, since anticoagulation of such patients may result in more risk than benefit, while continuing to be watchful for the development of prolonged episodes of AF, which, given a high enough risk of stroke (e.g., high CHA2DS2-VASc score), will strongly indicate that anticoagulation is necessary,” Dr. Swiryn concluded.
“Our data adds support to many other reports showing that anticoagulation to prevent stroke remains appropriate in patients, even (and perhaps especially) in older patients with prolonged episodes of atrial fibrillation,” he said.
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One Response to “Episodes of Atrial Tachyarrhythmias Detected by Cardiac Rhythm Devices Appear Benign”
November 14, 2016
Franz ReichsmanThis report seems to be in direct opposition to current recommendations with regard to anticoagulation in AF. While I’m not a specialist, from what I’ve previously read, episodes of AF as brief as six minutes are associated with an increased risk of stroke, and warrant anticoagulation. Perhaps a more precise definition of a brief episode is needed, or at least a more specific indication of the duration of a single electrogram recording than is given in this report. It makes sense to me that truly brief episodes (a few seconds?) of AF would pose little risk of thrombus formation, but as always, further investigation is needed.