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Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation
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Primary stroke prevention: a paradigm shift focusing on silent paroxysmal atrial fibrillation

A Schattner1

  • 1From the Faculty of Medicine, Hebrew University and Hadassah Medical School, Jerusalem, Israel.

QJM : Monthly Journal of the Association of Physicians
|June 20, 2018
PubMed

Insights

Silent sub-clinical atrial fibrillation (SCAF) is common in older adults and raises stroke risk. Active screening and early treatment with anticoagulants for high-risk elderly patients can reduce mortality and morbidity.

Area of Science:

  • Cardiology
  • Neurology
  • Geriatrics

Background:

  • Silent sub-clinical atrial fibrillation (SCAF) is highly prevalent in the elderly.
  • SCAF significantly increases the risk of stroke and cardiovascular mortality.
  • Current detection methods for atrial fibrillation are often reactive and limited.

Purpose of the Study:

  • To advocate for a proactive approach to identify high-risk elderly individuals with SCAF.
  • To emphasize the importance of early detection and intervention for SCAF.
  • To reduce SCAF-associated morbidity and mortality in the aging population.

Main Methods:

  • Review of prevalence, predictability, prognosis, and preventability of atrial fibrillation and cardiogenic brain embolism.
  • Focus on identifying SCAF in individuals over 65.
  • Utilizing readily available clinical, electrocardiographic, echocardiographic, and laboratory markers for risk assessment.

Main Results:

  • SCAF is a common and significant risk factor for stroke in the elderly.
  • Routine evaluation of specific markers can identify high-risk patients.
  • Early detection facilitates timely treatment with direct oral anticoagulants.

Conclusions:

  • A proactive screening strategy for SCAF in the elderly is warranted.
  • Early identification and treatment of SCAF can significantly decrease stroke risk and mortality.
  • Integrating SCAF detection into general practice and specialist consultations is feasible and beneficial.

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