Tactics of anticoagulant therapy in patients with cardiac implantable electronic devices and subclinical atrial fibrillation: A review

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Abstract

Screening for atrial fibrillation (AF) has attracted considerable attention recently. Of special interest are patients with cardiac implantable electronic devices (CIEDs) that allow for recording episodes of atrial arrhythmias of various durations, including asymptomatic ones, in which case they are referred to as subclinical atrial fibrillation (SCAF). The available data suggest that the risk of thromboembolic events varies between patients with SCAF and clinically overt AF. As of today, the question regarding anticoagulant therapy in patients with SCAF remains unresolved. The article presents an overview of previous and ongoing studies on this issue, as well as current guidelines on anticoagulant use in patients with SCAF and CIEDs.

About the authors

Tatiana V. Razina

Sechenov First Moscow State Medical University (Sechenov University)

Email: yamarfa@yandex.ru
ORCID iD: 0009-0006-9631-3547

аспирант каф. кардиологии, функциональной и ультразвуковой диагностики Института клинической медицины им. Н.В. Склифосовского

Russian Federation, Moscow

Maria V. Serova

Sechenov First Moscow State Medical University (Sechenov University); Pirogov City Clinical Hospital №1 Moscow

Author for correspondence.
Email: yamarfa@yandex.ru
ORCID iD: 0000-0003-0608-9205

канд. мед. наук, доц. каф. кардиологии, функциональной и ультразвуковой диагностики Института клинической медицины им. Н.В. Склифосовского ФГАОУ ВО «Первый МГМУ им. И.М. Сеченова» (Сеченовский Университет), врач-кардиолог отделения хирургического лечения сложных нарушений ритма сердца и электрокардиостимуляции ГБУЗ «ГКБ №1 им. Н.И. Пирогова»

Russian Federation, Moscow; Moscow

Denis A. Andreev

Sechenov First Moscow State Medical University (Sechenov University)

Email: yamarfa@yandex.ru
ORCID iD: 0000-0002-0276-7374

доктор мед. наук, проф., зав. каф. кардиологии, функциональной и ультразвуковой диагностики Института клинической медицины им. Н.В. Склифосовского

Russian Federation, Moscow

Yulia S. Sazonova

Pirogov City Clinical Hospital №1 Moscow

Email: yamarfa@yandex.ru
ORCID iD: 0000-0002-7825-3513

канд. мед. наук, врач-кардиолог отделения хирургического лечения сложных нарушений ритма сердца и электрокардиостимуляции

Russian Federation, Moscow

Anna G. Komarova

Botkin City Clinical Hospital Moscow

Email: yamarfa@yandex.ru
ORCID iD: 0000-0002-8633-7012

канд. мед. наук, зам. глав. врача по мед. части (по Региональному сосудистому центру)

Russian Federation, Moscow

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Supplementary files

Supplementary Files
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1. JATS XML
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2. Fig. 1. Progression of atrial high-rate episode burden (а) and stroke rates according to AHRE daily burden and CHA2DS2-VASc score (b).

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3. Fig. 2. Proposed management of AHRE/subclinical AF.

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4. Fig. 3. Data from an implantable device (Zephyr DR, St. Jude Medical).

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5. Fig. 4. Data from an implantable device (Medtronic, Adapta DR).

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