Silent atrial fibrillation: epidemiology, diagnosis, and clinical impact

Silent or subclinical asymptomatic atrial fibrillation (SAF) has currently gained wide interest in the epidemiologic, neurologic, and cardiovascular communities. It is well known that the electrophysiological and mechanical effects of symptomatic and silent atrial fibrillation (AF) are the same. It...

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Bibliographic Details
Published in:Clinical cardiology (Mahwah, N.J.) N.J.), 2017-06, Vol.40 (6), p.413-418
Main Authors: Dilaveris, Polychronis E., Kennedy, Harold L.
Format: Article
Language:English
Subjects:
Atrial Fibrillation - diagnosis
Atrial Fibrillation - epidemiology
Atrial Fibrillation - physiopathology
Cardiac arrhythmia
Electrocardiography
Electrocardiography, Ambulatory
Global Health
Humans
Incidence
Mortality
Prevalence
Quality of Life
Review
Reviews
Risk Assessment
Risk Factors
silent atrial fibrillation, atrial fibrillation burden, diagnosis, epidemiology, clinical consequences
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Summary:Silent or subclinical asymptomatic atrial fibrillation (SAF) has currently gained wide interest in the epidemiologic, neurologic, and cardiovascular communities. It is well known that the electrophysiological and mechanical effects of symptomatic and silent atrial fibrillation (AF) are the same. It is probable that because “AF begets AF,” progression from paroxysmal to persistent or permanent AF might be more rapid in patients with long‐term unrecognized and untreated SAF, because no treatment is sought by or provided to such patients. Moreover, SAF is common and has significant clinical implications. The clinical consequences of SAF, which include emboli (silent or symptomatic), heart failure, and early mortality, are of paramount importance. Consequently, SAF should be considered in estimating the prevalence of the disease and its impact on morbidity, mortality, and quality of life. Several diagnostic methods of arrhythmia detection utilizing the surface electrocardiogram (ECG), subcutaneous ECG, or intracardiac devices have been utilized to seek meaningful arrhythmic markers of SAF. Whereas a wide range of clinical risk factors of SAF have been validated in the literature, there is an ongoing search for those arrhythmic risk factors that precisely identify and prognosticate outcome events in diverse populations at risk of SAF. Modern diagnostic modalities for the identification of SAF exist, but should be further explored, validated, and tailored to each patient needs. The scientific community should undertake the clinical challenge of identifying and treating SAF.
ISSN:0160-9289
1932-8737
DOI:10.1002/clc.22667