-

January 13th, 2012

Podcast 141: Clinically apparent atrial fibrillation increases stroke risk; does subclinical afib do the same?

(4 votes, average: 2.75 out of 5)

Yes, it apparently does.

An international study in the New England Journal of Medicine monitored subclinical atrial fibrillation among some 2600 patients who’d just received an implanted pacemaker or cardioverter-defibrillator.

After 3 months of monitoring, about 10% of the group showed subclinical episodes of afib lasting at least 6 minutes.

Over an additional 2.5 years of follow-up the patients initially showing subclinical afib were found to have at least twice the risk for stroke or systemic thromboembolism compared with the rest of the group.

What does it all mean to clinicians? Should anticoagulation measures be taken in patients showing subclinical afib?

Dr. Stuart J. Connolly, one of the study’s principal authors, chatted with Clinical Conversations, offering some clinical guidance on what to do while the apparent magnitude of the effect is investigated further.

Links:

Physician’s First Watch coverage (free)

New England Journal of Medicine abstract (free)

Leave a Reply

Note: This is a moderated forum. By clicking on the "Submit Comment" button below, you agree to abide by the NEJM Journal Watch Terms of Use.

Our physician bloggers cannot respond to requests for personal medical advice, and recommend patients discuss health issues with their individual physicians.

Clinical Conversations

About the Podcast

To subscribe: Subscribe on iTunes

To have your comment included in a future podcast, call 617-440-4374. Please leave your name, number, and the podcast ID number.