Detection and management of subclinical atrial fibrillation in implantable and wearable devices

Abstract

This mini review lists available data on detection of subclinical atrial fibrillation (SCAF) in patients with cardiac implantable electronic devices and underlines uncertainties that remain when it comes to anticoagulation. Ongoing trials will examine the benefit of anticoagulation in these patients when SCAF duration is in the grey zone between 5–6 minutes and 24 hours. Meanwhile, smart and wearable devices may lead to a more patient-driven than physician-driven diagnostic in detection of AF. Wearables come with opportunities and challenges and cardiologists will need to focus on the right balance between using wearables as an additional diagnostic tool in patients at risk while avoiding overdiagnosis in the healthy general population.