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Subclinical atrial fibrillation (SCAF) episodes are frequently detected in patients with cardiac implantable electronic devices (CIEDs). These asymptomatic arrhythmias are increasingly recognized as potential harbingers of clinical atrial fibrillation and thromboembolic events. However, the management of SCAF-particularly regarding the use of oral anticoagulation (OAC)-remains controversial. This literature review (Medline, Scopus, Goggle scholar, Embase) focuses on using current literature and clinical studies to guide decision-making regarding anticoagulation therapy and other treatment options that can limit complications for patients with SCAF. The decision to initiate anticoagulation in patients with atrial high-rate episodes (AHREs) should be individualized, balancing stroke risk against bleeding potential. Ongoing research and post hoc analyses will further clarify which subgroups may benefit most from therapy, informing future guideline recommendations.
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http://dx.doi.org/10.3390/jcm14155222 | DOI Listing |
J Palliat Care
September 2025
Department of Healthcare Administration and Policy, School of Public Health, University of Nevada, Las Vegas, NV, USA.
ObjectivesRecently, atrial fibrillation (AF) has contributed to an increase in cardiovascular deaths in the U.S. Palliative care (PC) and atrial ablation (AA) procedure can elevate quality of life of high-risk AF patients, who are associated with multiple comorbidities.
View Article and Find Full Text PDFEuropace
September 2025
Department of Cardiology and Vascular Medicine, University Heart and Vascular Center Frankfurt, Goethe University Frankfurt, Frankfurt am Main, Germany.
Background And Aims: Aim of this study was to assess the risk of hemolysis, the extent of myocardial and neural injury after monopolar, monophasic pulsed field ablation (PFA) using a lattice-tip catheter in comparison to single-shot PF ablation platforms employing bipolar, biphasic waveforms.
Methods: This prospective study included consecutive patients undergoing PFA for atrial fibrillation (AF) using the Affera™ mapping and ablation system (n=40). Biomarkers for hemolysis (haptoglobin, LDH, bilirubin), myocardial injury (high-sensitive troponin T, CK, CK-MB), neurocardiac injury (S100), and renal function (creatinine) were assessed pre- and within 24 hours post-ablation.
World J Pediatr Congenit Heart Surg
September 2025
Department of Pediatric Cardiac Surgery, National Institute of Cardiovascular Diseases, Karachi, Pakistan.
Severe tricuspid regurgitation (TR) can lead to significant enlargement of the right atrium (RA) and poses unique clinical challenges. We report this case of a 17-year-old boy previously misdiagnosed with Ebstein anomaly who presented with dyspnea and palpitations. Initial examination revealed irregular heart rhythm, distended neck veins, and a significant murmur.
View Article and Find Full Text PDFJAMA Netw Open
September 2025
City St George's, University of London, London, UK.