title: Device-Detected Atrial Fibrillation-Perils and Pitfalls: An Update.
abstract: Stroke and thromboembolism are catastrophic complications of atrial fibrillation (AF). Cardiac implantable electronic devices (CIED) with an atrial lead can reliably detect atrial high-rate events (AHRE). However, this correlation may be imperfect because of oversensing and undersensing of atrial signals and spurious arrhythmias. The critical duration, frequency, or overall burden of AHRE that increases stroke risk is still unknown; thus, the threshold level of AHRE (duration and frequency) that warrants anticoagulation in patients with CIED-detected AHRE is still unclear. This article reviews current literature on the risk of stroke with CIED-detected AHRE and raises questions that need further clarification.
authors.affiliation: Sparrow Thoracic and Cardiovascular Institute, Michigan State University, Lansing, MI, USA.
authors.forename: Phani
authors.initials: P
authors.lastname: Surapaneni
authors.affiliation: Sparrow Thoracic and Cardiovascular Institute, Michigan State University, Lansing, MI, USA.
authors.forename: Abdul
authors.initials: A
authors.lastname: Safadi
authors.affiliation: Department of Cardiology, Lehigh Valley Health Network, 1240 South Cedar Crest Boulevard, Allentown, PA 18103, USA.
authors.forename: Tahmeed
authors.initials: T
authors.lastname: Contractor
authors.affiliation: Department of Clinical Cardiac Electrophysiology, The Bay Pines Veterans Affairs Health Care System, University of South Florida, Tampa, 10000 Bay Pines Boulevard, Bay Pines, FL 33744, USA.
authors.forename: Mehul B
authors.initials: MB
authors.lastname: Patel
authors.affiliation: Sparrow Thoracic and Cardiovascular Institute, Michigan State University, Lansing, MI, USA. Electronic address: thakur@msu.edu.
authors.forename: Ranjan K
authors.initials: RK
authors.lastname: Thakur
mesh_terms: D001281:Atrial Fibrillation / Q000175:diagnosis* / Q000503:physiopathology; D058409:Cardiac Resynchronization Therapy Devices; D004562:Electrocardiography; D006325:Heart Atria / Q000503:physiopathology*; D006801:Humans; D015203:Reproducibility of Results; D018570:Risk Assessment; D012307:Risk Factors
keywords: Anticoagulation; Atrial fibrillation; Cardioembolism; Stroke