Atrial High-Rate Episodes and Subclinical Atrial Fibrillation: State of the Art and Clinical Questions with Complex Solutions.

IF 16.4 1区化学 Q1 CHEMISTRY, MULTIDISCIPLINARY

Accounts of Chemical Research Pub Date : 2024-08-22 eCollection Date: 2024-08-01 DOI:10.31083/j.rcm2508305

Carola Griffith Brookles, Roberto De Ponti, Vincenzo Russo, Matteo Ziacchi, Gemma Pelargonio, Michela Casella, Maurelio Lauretti, Manola Vilotta, Sakis Themistoclakis, Antonio D'Onofrio, Giuseppe Boriani, Matteo Anselmino

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引用次数: 0

Abstract

Atrial high-rate episodes (AHREs) and subclinical atrial fibrillation (AF) are frequently registered in asymptomatic patients with cardiac implantable electronic devices (CIEDs) and insertable cardiac monitors (ICMs). While an increased risk of thromboembolic events (e.g., stroke) and benefits from anticoagulation have been widely assessed in the setting of clinical AF, concerns persist about optimal clinical management of subclinical AF/AHREs. As a matter of fact, an optimal threshold of subclinical episodes' duration to predict stroke risk is still lacking and recently published randomized clinical trials assessing the impact of anticoagulation on thromboembolic events in this specific setting have shown contrasting results. The aim of this review is to summarize current evidence regarding classification and clinical impact of subclinical AF/AHREs and to discuss the latest evidence regarding the potential benefit of anticoagulation in this setting, highlighting which clinical questions are still unanswered.

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心房高频率发作和亚临床心房颤动：技术现状和复杂解决方案的临床问题。

使用心脏植入式电子设备（CIED）和插入式心脏监护仪（ICM）的无症状患者中经常会出现心房高频率发作（AHRE）和亚临床心房颤动（AF）。虽然临床房颤会增加血栓栓塞事件（如中风）的风险，而且抗凝治疗的益处已得到广泛评估，但亚临床房颤/AHREs 的最佳临床管理仍令人担忧。事实上，目前仍缺乏预测中风风险的亚临床发作持续时间的最佳阈值，最近发表的评估抗凝对这种特定情况下血栓栓塞事件影响的随机临床试验也显示出截然不同的结果。本综述旨在总结有关亚临床房颤/急性心房颤动的分类和临床影响的现有证据，并讨论有关在这种情况下抗凝治疗的潜在益处的最新证据，同时强调哪些临床问题仍未得到解答。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Accounts of Chemical Research 化学-化学综合

CiteScore

31.40

自引率

1.10%

发文量

312

审稿时长

2 months

期刊介绍： Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.