How early is early enough to prevent stroke in atrial fibrillation?

Abstract

Evaluation of: Healey JS, Connolly SJ, Gold MR et al. Subclinical atrial fibrillation and the risk of stroke. N. Engl. J. Med. 366(2), 120–129 (2012).

Atrial fibrillation (AF) is a potent risk factor for stroke, being responsible for 20% of ischemic strokes. Subclinical AF burden has received much attention, especially in the context of patients with cryptogenic strokes. However, little is known about the impact of subclinical episodes of rapid atrial rate and the primary risk of stroke and systemic embolism. Healey et al. investigated whether subclinical rapid atrial rate detected by implanted devices was associated with the risk of ischemic stroke in patients without clinical evidence of AF. The current article discusses the potential implications of the above results.

Keywords::

• atrial fibrillation
• early prevention
• high-rate atrial episodes
• stroke

Financial & competing interests disclosure

GYH Lip and S Apostolakis have received research funding and honoraria from various pharmaceutical companies in relation to atrial fibrillation for meetings and educational symposia. In addition, GYH Lip is a member of advisory boards and trial steering committees. He was clinical advisor to the UK national NICE Guidelines on atrial fibrillation management and on the writing group for the European Society of Cardiology guidelines on atrial fibrillation management. GYH Lip is a panellist on the revised (9th Edition) American College of Chest Physicians Guidelines on Antithrombotic Therapy. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.