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Related Experiment Video

Updated: Jan 29, 2026

The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation
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Predictors for Device-Detected Subclinical Atrial Fibrillation: An Up-to-Date Narrative Review.

Traian Chiuariu1,2, Larisa Anghel1,2, Delia Melania Popa1,2

  • 1Internal Medicine Department, "Grigore T. Popa" University of Medicine and Pharmacy, 700503 Iași, Romania.

Journal of Clinical Medicine
|January 28, 2026
PubMed
Summary

Device-detected subclinical atrial fibrillation (SCAF) and atrial high-rate episodes (AHRE) are linked to increased risks. A combined approach using clinical data, ECG, echocardiography, and biomarkers can identify patients at risk for SCAF.

Keywords:
atrial high-rate episodesatrial straincardiac implantable electronic devicespredictive factorssubclinical atrial fibrillation

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Area of Science:

  • Cardiology
  • Biomedical Engineering

Background:

  • Device-detected subclinical atrial fibrillation (SCAF) and atrial high-rate episodes (AHRE) are increasingly recognized.
  • These episodes, though often asymptomatic, are associated with higher risks of clinical AF, stroke, and heart failure.

Purpose of the Study:

  • To review clinical, electrocardiographic, echocardiographic, and circulating biomarkers linked to SCAF/AHRE development and progression.
  • To summarize factors associated with device-detected SCAF and AHRE.

Main Methods:

  • A comprehensive literature search of PubMed, Embase, and Scopus was conducted.
  • Included studies focused on patients with cardiac implantable electronic devices or long-term monitoring, reporting SCAF/AHRE or AF outcomes within the last 10 years.

Main Results:

  • Clinical factors (age, BMI, heart failure, OSA, C2HEST score) and ECG parameters (P-wave indices, atrial sensing amplitude, pacing configurations) predict SCAF/AHRE.
  • Echocardiographic markers of atrial cardiomyopathy and left ventricular diastolic dysfunction refine risk assessment.
  • Biomarkers like galectin-3 and hs-CRP show associations with incident AHRE.

Conclusions:

  • A multiparametric approach combining clinical, ECG, echocardiographic, and biomarker data may enhance SCAF risk identification.
  • Further prospective studies are needed to establish risk thresholds for intensified monitoring and early treatment strategies, particularly for short AHRE.