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Stroke incidence and anticoagulation treatment in patients with pacemaker-detected silent atrial fibrillation

Emma Sandgren1,2, Cecilia Rorsman1, Nils Edvardsson3

  • 1Department of Medicine, Halland Hospital Varberg, Varberg, Sweden.

Plos One
|September 14, 2018
PubMed

Insights

Silent atrial fibrillation (AF) is common, and anticoagulation may reduce stroke risk. Further research is needed to determine optimal treatment for patients with silent AF.

Area of Science:

  • Cardiology
  • Neurology

Background:

  • Silent atrial fibrillation (AF) is prevalent, yet its optimal management, particularly anticoagulation, remains debated.
  • Patients with pacemakers are at risk for developing silent AF.

Purpose of the Study:

  • To investigate the incidence of silent AF in pacemaker patients.
  • To assess the impact of anticoagulation on stroke and dementia risk in patients with and without AF.

Main Methods:

  • Retrospective analysis of consecutive patients with dual-chamber pacemakers.
  • Recording of silent AF development, anticoagulation status, and incidence of ischemic stroke and dementia.

Main Results:

  • 30% of patients without known AF at implant developed silent AF during follow-up.
  • Stroke incidence was similar in patients with known AF (2.1%) and silent AF (1.9%).
  • Vascular dementia was more common in patients with known AF (11.2%) compared to those without AF (6.2%).

Conclusions:

  • Anticoagulation may significantly reduce stroke risk in patients with silent AF.
  • Vascular dementia risk is elevated in patients with known AF.
  • More data is required to guide optimal anticoagulation strategies for silent AF.
Abstract

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