FRINK Linked Data Fragments server

Matches in SemOpenAlex for { <https://semopenalex.org/work/W2154667788> ?p ?o ?g. }

• W2154667788 endingPage "251" @default.
• W2154667788 startingPage "249" @default.
• W2154667788 abstract "HomeCirculation: Arrhythmia and ElectrophysiologyVol. 8, No. 2Asymptomatic Atrial Fibrillation After Cryptogenetic Stroke Free AccessEditorialPDF/EPUBAboutView PDFView EPUBSections ToolsAdd to favoritesDownload citationsTrack citationsPermissions ShareShare onFacebookTwitterLinked InMendeleyReddit Jump toFree AccessEditorialPDF/EPUBAsymptomatic Atrial Fibrillation After Cryptogenetic StrokeIncidence, Clinical Significance, and Therapeutic Implications Antonio Raviele, MD, FESC Antonio RavieleAntonio Raviele From the Alliance to Fight Atrial Fibrillation, Venice, Italy. Search for more papers by this author Originally published1 Apr 2015https://doi.org/10.1161/CIRCEP.115.002835Circulation: Arrhythmia and Electrophysiology. 2015;8:249–251Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia, with a prevalence of 1% to 2% in the general population; this increases with age, reaching >8% in subjects over 80 years of age.1,2 The arrhythmia is independently associated with an increased risk of stroke, which is about 5-fold higher in AF-affected patients than in controls.3 AF is considered to be the cause of ischemic stroke in 15% to 17% of cases.3,4 Interestingly, AF-related strokes cause higher mortality and disability than strokes unrelated to AF4,5 and stroke risk is independent of the type of AF (paroxysmal, persistent, or permanent).6,7 The rate of stroke caused by AF can be significantly reduced (by 60% to 70%) by the use of warfarin or novel oral anticoagulants.8,9Article see p 263AF is usually symptomatic, causing symptoms, such as palpitations, dyspnea, fatigue, angina, dizziness, and syncope.10 Not rarely, however, the arrhythmia is not perceived at all by the patient and, in this case, is defined as asymptomatic, silent, undetected, occult, or subclinical AF.According to the EURObservational Research Programme–AF (EORP-AF) Pilot General Registry, almost 40% of the AF patients who are seen in daily cardiology practice are completely asymptomatic, and another 30% have only mild symptoms.11 The prevalence of silent AF varies in different clinical settings, ranging from 0% to 31% in postablation patients12,13 to 16% to 25% as incidental finding at standard ECG,2,14 54% to 70% in patients treated with antiarrhythmic drugs, and 15,16 up to 51% to 74% in pacemaker/implantable cardioverter- defibrillator recipients.17,18Stroke is the leading cause of long-term adult disability and mortality in the developed world. Approximately, 30% to 40% of all strokes are cryptogenetic or caused by unknown causes.19,20 A possible explanation for these strokes is occult or subclinical AF. Several studies have shown that the incidence of silent AF after an undiagnosed stroke may be as high as 5% to 20%.21 In daily clinical practice, it is important after cryptogenetic stroke to detect episodes of silent AF to start appropriate anticoagulation therapy and reduce the risk of future events.In this issue of Circulation: Arrhythmia and Electro physiology, Dussault et al22 report a systematic review and meta-analysis of electrocardiographic monitoring to detect AF after undiagnosed ischemic stroke or transient ischemic attack. The main purpose of the meta-analysis was to assess the relationship between the duration of ECG monitoring and the proportion of newly diagnosed AF. A total of 31 studies met the inclusion criteria (including 3 randomized controlled trials). The overall proportion of newly detected AF was 7.4%: 5.1% on short (<3 days) and 15% on long (>7 days) ECG monitoring. Extending ECG monitoring from 24 hours to 30 and 180 days increased the detection of AF from 4.2% to 15.2% and 29.15%, respectively. In the 3 randomized controlled trials,23–25 long-term monitoring was associated with 7.26 odds of detecting AF in comparison with traditional short-term monitoring.These results clearly show that more is better than less with regard to monitoring for the detection of asymptomatic AF after cryptogenetic stroke and support the recent guideline recommendation of at least 30 days of ECG monitoring after a stroke with undiagnosed cause.26The main limitation of this article is the significant degree of heterogeneity observed among studies and the inability to detect the potential sources of this heterogeneity, despite subgroup analyses performed by the authors on prespecified variables. Indeed, many other factors, besides the length of monitoring, can influence the detection rates of AF in patients with cryptogenetic stroke. These include the definition of AF duration that constitutes an episode (>30 seconds, >2 minutes, > 6 minutes, etc), the interval from the index stroke to the start of monitoring (from hours to days or months), and patient characteristics and selection (age and sex of patients, presence of comorbidities, type and burden of AF, value of CHADS2 or CHA2DS2-VASc risk score systems, etc).Despite this limitation, it is evident that silent AF is a common finding in patients with cryptogenetic stroke if prolonged electrocardiographic monitoring is performed soon after the index event, reaching ≤30% at 3 months if an implantable loop recorder is used.22But what is the clinical and prognostic significance of silent AF after cryptogenetic stroke? At present, the literature is lacking in data on this issue; the only information we have is indirect and comes from patients treated with implantable electronic devices (pacemaker, implantable cardioverter-defibrillator, or CRT device) for an arrhythmic problem.17,18,27–31 In these patients, detection of silent AF by the device is associated with an increased risk of thrombo-embolic events, with a hazard ratio ranging from 2.2 to 9.4.32 According to a recent cohort study, asymptomatic AF is also associated with increased mortality (doubled compared with controls)33; the mortality is even higher than that observed in symptomatic AF (9.4% versus 4.2% at 1 year, in the EORP-AF Pilot General Registry).11 However, it is not yet known what length of silent AF episodes or what amount of silent AF burden convey a substantial risk. Indeed, according to literature data, the length of asymptomatic episodes of AF that is associated with an increased risk of stroke varies from a minimum of 5 minutes in the Ancillary MOST (Mode Selection Trial)17 to 6 minutes in the Asymptomatic AF and Stroke Evaluation in Pacemaker Patients and the AF Reduction Atrial Pacing Trial (ASSERT),30 1 hour in the SOS-AF (Stroke Prevention Strategies Based on AF Information From Implanted Devices) Project,31 3.8 hours in the Home Monitor CRT trial,29 5.5 hours in the prospective study of the clinical significance of atrial arrhythmias detected by implanted device diagnostics (TRENDS) trial,28 to a maximum of 24 hours in the Italian AT500 Registry.18 From these data, it seems evident that the episode duration and burden of asymptomatic AF that best predict subsequent stroke are still matters of debate and need to be addressed by future studies.Another important issue is the relationship between silent AF and stroke; in other words, is silent AF the direct cause of the stroke or just a marker of an increased risk? The TRENDS, ASSERT, and the multicenter randomized study of anticoagulation guided by remote rhythm monitoring in patients with implantable cardioverter-defibrillator and CRT-D devices (IMPACT) trials have tried to answer this question by investigating the temporal relationship between device-detected AF and thrombo-embolic events.34–36 In the majority of patients (73% to 94%), no AF was found on device recordings in the 30 days before the thrombo-embolic event. Moreover, when AF was detected, this happened >30 days before thrombo-embolic events in 29% to 50% of cases and after thrombo-embolic events in 3% to 16% of cases.32 These results indicate that a proximate temporal relationship between asymptomatic AF and stroke occurrence does not exist and suggest that silent AF is not the direct cause of the stroke in the majority of cases of device-detected AF.These results also call into question our current understanding of how AF causes embolic events. It is likely that multiple mechanisms contribute to stroke in patients with asymptomatic AF.34 In some cases, stroke may be caused by stasis from an actual AF episode, in others, to chronic atrial and endothelial changes caused by multiple prior AF episodes; and in other cases again, to non-AF mechanisms. In these latter cases, it may be that the AF is simply a marker of increased stroke from any cause because of its relationship to other comorbidities, such as heart failure, hypertension, diabetes mellitus, occult atrial myopathy, endothelial dysfunction, or other vascular disease risk factors summarized by the CHA2DS2-VASc scoring system.The uncertain causal relationship between asymptomatic AF and stroke also raises the issue of the therapeutic implications of this arrhythmia. From a therapeutic point of view, the detection of asymptomatic AF in patients with cryptogenetic stroke is important to establish the need for oral anticoagulation. In these patients, the detection of asymptomatic AF may allow early initiation of anticoagulation, instead of the usual care with antiplatelet therapy, and may lead to a reduction in the risk of recurrent stroke. However, it is important to point out that no prospective randomized trials using oral anticoagulation have been performed in this field to date. Furthermore, the lack of a proximate temporal relationship between asymptomatic AF and stroke observed in the majority of patients in the ASSERT, TRENDS, and IMPACT trials34–36 suggests that oral anticoagulation may not be systematically required for stroke prevention in asymptomatic patients. However, it is common opinion that anticoagulation is indicated in patients with cryptogenetic stroke and asymptomatic AF because a history of prior stroke already confers a high thrombo-embolic risk (CHA2DS2-VASc score of at least 2), which itself should prompt the use of oral anticoagulants according to current American and European guidelines.26,37In conclusion, prolonged electrocardiographic monitoring, especially the use of an implantable loop recorder, enables silent AF to be detected in a high proportion of patients with cryptogenetic stroke (≤30%) and should be encouraged and preferred to conventional short-term monitoring. Although the prognosis of asymptomatic AF seems to be the same as—or even worse than—that of symptomatic AF, further trials are needed to establish the length and burden of silent AF episodes that convey a greater risk of stroke. Finally, despite the lack of randomized trials on the benefit of oral anticoagulation therapy, it is reasonable to prescribe this therapy for patients with cryptogenetic stroke and silent AF, who are, by definition, at high risk of recurrent thrombo-embolic events.DisclosuresNone.FootnotesThe opinions expressed in this article are not necessarily those of the editors or of the American Heart Association.Correspondence to Antonio Raviele, MD, FESC, President of ALFA—Alliance to Fight Atrial Fibrillation, Via Torino 151/c, 30174 Mestre–Venice, Italy. E-mail [email protected]References1. Go AS, Hylek EM, Phillips KA, Chang Y, Henault LE, Selby JV, Singer DE.Prevalence of diagnosed atrial fibrillation in adults: national implications for rhythm management and stroke prevention: the AnTicoagulation and Risk Factors in Atrial Fibrillation (ATRIA) Study.JAMA. 2001; 285:2370–2375.CrossrefMedlineGoogle Scholar2. Miyasaka Y, Barnes ME, Gersh BJ, Cha SS, Bailey KR, Abhayaratna WP, Seward JB, Tsang TS.Secular trends in incidence of atrial fibrillation in Olmsted County, Minnesota, 1980 to 2000, and implications on the projections for future prevalence.Circulation. 2006; 114:119–125. doi: 10.1161/CIRCULATIONAHA.105.595140.LinkGoogle Scholar3. Wolf PA, Abbott RD, Kannel WB.Atrial fibrillation as an independent risk factor for stroke: the Framingham Study.Stroke. 1991; 22:983–988.LinkGoogle Scholar4. Lamassa M, Di Carlo A, Pracucci G, Basile AM, Trefoloni G, Vanni P, Spolveri S, Baruffi MC, Landini G, Ghetti A, Wolfe CD, Inzitari D.Characteristics, outcome, and care of stroke associated with atrial fibrillation in Europe: data from a multicenter multinational hospital-based registry (The European Community Stroke Project).Stroke. 2001; 32:392–398.LinkGoogle Scholar5. Steger C, Pratter A, Martinek-Bregel M, Avanzini M, Valentin A, Slany J, Stöllberger C.Stroke patients with atrial fibrillation have a worse prognosis than patients without: data from the Austrian Stroke registry.Eur Heart J. 2004; 25:1734–1740. doi: 10.1016/j.ehj.2004.06.030.CrossrefMedlineGoogle Scholar6. Hart RG, Pearce LA, Rothbart RM, McAnulty JH, Asinger RW, Halperin JL.Stroke with intermittent atrial fibrillation: incidence and predictors during aspirin therapy. Stroke Prevention in Atrial Fibrillation Investigators.J Am Coll Cardiol. 2000; 35:183–187.CrossrefMedlineGoogle Scholar7. Hohnloser SH, Pajitnev D, Pogue J, Healey JS, Pfeffer MA, Yusuf S, Connolly SJ; ACTIVE W Investigators. Incidence of stroke in paroxysmal versus sustained atrial fibrillation in patients taking oral anticoagulation or combined antiplatelet therapy: an ACTIVE W Substudy.J Am Coll Cardiol. 2007; 50:2156–2161. doi: 10.1016/j.jacc.2007.07.076.CrossrefMedlineGoogle Scholar8. Hart RG, Pearce LA, Aguilar MI.Meta-analysis: antithrombotic therapy to prevent stroke in patients who have nonvalvular atrial fibrillation.Ann Intern Med. 2007; 146:857–867.CrossrefMedlineGoogle Scholar9. Ruff CT, Giugliano RP, Braunwald E, Hoffman EB, Deenadayalu N, Ezekowitz MD, Camm AJ, Weitz JI, Lewis BS, Parkhomenko A, Yamashita T, Antman EM.Comparison of the efficacy and safety of new oral anticoagulants with warfarin in patients with atrial fibrillation: a meta-analysis of randomised trials.Lancet. 2014; 383:955–962. doi: 10.1016/S0140-6736(13)62343-0.CrossrefMedlineGoogle Scholar10. Lévy S, Maarek M, Coumel P, Guize L, Lekieffre J, Medvedowsky JL, Sebaoun A.Characterization of different subsets of atrial fibrillation in general practice in France: the ALFA study. The College of French Cardiologists.Circulation. 1999; 99:3028–3035.LinkGoogle Scholar11. Boriani G, Laroche C, Diemberger I, Fantecchi E, Popescu MI, Rasmussen LH, Sinagra G, Petrescu L, Tavazzi L, Maggioni AP, Lip GY.Asymptomatic atrial fibrillation: clinical correlates, management and outcomes in the EORP-AF Pilot General Registry.Am J Med. 2014Dec 19. pii: S0002-9343(14)01207-8. doi: 10.1016/j.amjmed.2014.11.026. [Epub ahead of print]Google Scholar12. Steven D, Rostock T, Lutomsky B, Klemm H, Servatius H, Drewitz I, Friedrichs K, Ventura R, Meinertz T, Willems S.What is the real atrial fibrillation burden after catheter ablation of atrial fibrillation? A prospective rhythm analysis in pacemaker patients with continuous atrial monitoring.Eur Heart J. 2008; 29:1037–1042. doi: 10.1093/eurheartj/ehn024.CrossrefMedlineGoogle Scholar13. Manganiello S, Anselmino M, Amellone C, Pelissero E, Giuggia M, Trapani G, Giordano B, Senatore G, Gaita F.Symptomatic and asymptomatic long-term recurrences following transcatheter atrial fibrillation ablation.Pacing Clin Electrophysiol. 2014; 37:697–702. doi: 10.1111/pace.12387.CrossrefMedlineGoogle Scholar14. Nieuwlaat R, Capucci A, Camm AJ, Olsson SB, Andresen D, Davies DW, Cobbe S, Breithardt G, Le Heuzey JY, Prins MH, Lévy S, Crijns HJ; European Heart Survey Investigators. Atrial fibrillation management: a prospective survey in ESC member countries: the Euro Heart Survey on Atrial Fibrillation.Eur Heart J. 2005; 26:2422–2434. doi: 10.1093/eurheartj/ehi505.CrossrefMedlineGoogle Scholar15. Patten M, Maas R, Bauer P, Lüderitz B, Sonntag F, Dluzniewski M, Hatala R, Opolski G, Müller HW, Meinertz T; SOPAT Investigators. Suppression of paroxysmal atrial tachyarrhythmias–results of the SOPAT trial.Eur Heart J. 2004; 25:1395–1404. doi: 10.1016/j.ehj.2004.06.014.CrossrefMedlineGoogle Scholar16. Fetsch T, Bauer P, Engberding R, Koch HP, Lukl J, Meinertz T, Oeff M, Seipel L, Trappe HJ, Treese N, Breithardt G; Prevention of Atrial Fibrillation after Cardioversion Investigators. Prevention of atrial fibrillation after cardioversion: results of the PAFAC trial.Eur Heart J. 2004; 25:1385–1394. doi: 10.1016/j.ehj.2004.04.015.CrossrefMedlineGoogle Scholar17. Glotzer TV, Hellkamp AS, Zimmerman J, Sweeney MO, Yee R, Marinchak R, Cook J, Paraschos A, Love J, Radoslovich G, Lee KL, Lamas GA; MOST Investigators. Atrial high rate episodes detected by pacemaker diagnostics predict death and stroke: report of the Atrial Diagnostics Ancillary Study of the MOde Selection Trial (MOST).Circulation. 2003; 107:1614–1619. doi: 10.1161/01.CIR.0000057981.70380.45.LinkGoogle Scholar18. Capucci A, Santini M, Padeletti L, Gulizia M, Botto G, Boriani G, Ricci R, Favale S, Zolezzi F, Di Belardino N, Molon G, Drago F, Villani GQ, Mazzini E, Vimercati M, Grammatico A; Italian AT500 Registry Investigators. Monitored atrial fibrillation duration predicts arterial embolic events in patients suffering from bradycardia and atrial fibrillation implanted with antitachycardia pacemakers.J Am Coll Cardiol. 2005; 46:1913–1920. doi: 10.1016/j.jacc.2005.07.044.CrossrefMedlineGoogle Scholar19. Ionita CC, Xavier AR, Kirmani JF, Dash S, Divani AA, Qureshi AI.What proportion of stroke is not explained by classic risk factors?Prev Cardiol. 2005; 8:41–46.CrossrefMedlineGoogle Scholar20. Sacco RL, Ellenberg JH, Mohr JP, Tatemichi TK, Hier DB, Price TR, Wolf PA.Infarcts of undetermined cause: the NINCDS Stroke Data Bank.Ann Neurol. 1989; 25:382–390. doi: 10.1002/ana.410250410.CrossrefMedlineGoogle Scholar21. Seet RC, Friedman PA, Rabinstein AA.Prolonged rhythm monitoring for the detection of occult paroxysmal atrial fibrillation in ischemic stroke of unknown cause.Circulation. 2011; 124:477–486. doi: 10.1161/CIRCULATIONAHA.111.029801.LinkGoogle Scholar22. Dussault C, Toeg H, Nathan M, Wang ZJ, Roux JF, Secemsky E.Electrocardiographic monitoring for detecting atrial fibrillation after ischemic stroke or transient ischemic attack: systematic review and meta-analysis.Circ Arrhythm Electrophysiol. 2015; 8:263–269. doi: 10.1161/CIRCEP.114.002521.LinkGoogle Scholar23. Higgins P, MacFarlane PW, Dawson J, McInnes GT, Langhorne P, Lees KR.Noninvasive cardiac event monitoring to detect atrial fibrillation after ischemic stroke: a randomized, controlled trial.Stroke. 2013; 44:2525–2531. doi: 10.1161/STROKEAHA.113.001927.LinkGoogle Scholar24. Gladstone DJ, Spring M, Dorian P, Panzov V, Thorpe KE, Hall J, Vaid H, O’Donnell M, Laupacis A, Côté R, Sharma M, Blakely JA, Shuaib A, Hachinski V, Coutts SB, Sahlas DJ, Teal P, Yip S, Spence JD, Buck B, Verreault S, Casaubon LK, Penn A, Selchen D, Jin A, Howse D, Mehdiratta M, Boyle K, Aviv R, Kapral MK, Mamdani M; EMBRACE Investigators and Coordinators. Atrial fibrillation in patients with cryptogenic stroke.N Engl J Med. 2014; 370:2467–2477. doi: 10.1056/NEJMoa1311376.CrossrefMedlineGoogle Scholar25. Sanna T, Diener HC, Passman RS, Di Lazzaro V, Bernstein RA, Morillo CA, Rymer MM, Thijs V, Rogers T, Beckers F, Lindborg K, Brachmann J; CRYSTAL AF Investigators. Cryptogenic stroke and underlying atrial fibrillation.N Engl J Med. 2014; 370:2478–2486. doi: 10.1056/NEJMoa1313600.CrossrefMedlineGoogle Scholar26. January CT, Wann LS, Alpert JS, Calkins H, Cigarroa JE, Cleveland JC, Conti JB, Ellinor PT, Ezekowitz MD, Field ME, Murray KT, Sacco RL, Stevenson WG, Tchou PJ, Tracy CM, Yancy CW; American College of Cardiology/American Heart Association Task Force on Practice Guidelines. 2014 AHA/ACC/HRS guideline for the management of patients with atrial fibrillation: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the Heart Rhythm Society.J Am Coll Cardiol. 2014; 64:e1–76. doi: 10.1016/j.jacc.2014.03.022.CrossrefMedlineGoogle Scholar27. Botto GL, Padeletti L, Santini M, Capucci A, Gulizia M, Zolezzi F, Favale S, Molon G, Ricci R, Biffi M, Russo G, Vimercati M, Corbucci G, Boriani G.Presence and duration of atrial fibrillation detected by continuous monitoring: crucial implications for the risk of thromboembolic events.J Cardiovasc Electrophysiol. 2009; 20:241–248. doi: 10.1111/j.1540-8167.2008.01320.x.CrossrefMedlineGoogle Scholar28. Glotzer TV, Daoud EG, Wyse DG, Singer DE, Ezekowitz MD, Hilker C, Miller C, Qi D, Ziegler PD.The relationship between daily atrial tachyarrhythmia burden from implantable device diagnostics and stroke risk: the TRENDS study.Circ Arrhythm Electrophysiol. 2009; 2:474–480. doi: 10.1161/CIRCEP.109.849638.LinkGoogle Scholar29. Shanmugam N, Boerdlein A, Proff J, Ong P, Valencia O, Maier SK, Bauer WR, Paul V, Sack S.Detection of atrial high-rate events by continuous home monitoring: clinical significance in the heart failure-cardiac resynchronization therapy population.Europace. 2012; 14:230–237. doi: 10.1093/europace/eur293.CrossrefMedlineGoogle Scholar30. Healey JS, Connolly SJ, Gold MR, Israel CW, Van Gelder IC, Capucci A, Lau CP, Fain E, Yang S, Bailleul C, Morillo CA, Carlson M, Themeles E, Kaufman ES, Hohnloser SH; ASSERT Investigators. Subclinical atrial fibrillation and the risk of stroke.N Engl J Med. 2012; 366:120–129. doi: 10.1056/NEJMoa1105575.CrossrefMedlineGoogle Scholar31. Boriani G, Glotzer TV, Santini M, West TM, De Melis M, Sepsi M, Gasparini M, Lewalter T, Camm JA, Singer DE.Device-detected atrial fibrillation and risk for stroke: an analysis of >10,000 patients from the SOS AF project (Stroke preventiOn Strategies based on Atrial Fibrillation information from implanted devices).Eur Heart J. 2014; 35:508–516. doi: 10.1093/eurheartj/eht491.CrossrefMedlineGoogle Scholar32. Glotzer TV, Ziegler PD.Cryptogenic stroke: Is silent atrial fibrillation the culprit?Heart Rhythm. 2015; 12:234–241. doi: 10.1016/j.hrthm.2014.09.058.CrossrefMedlineGoogle Scholar33. Martinez C, Katholing A, Freedman SB.Adverse prognosis of incidentally detected ambulatory atrial fibrillation. A cohort study.Thromb Haemost. 2014; 112:276–286. doi: 10.1160/TH4-04-0383.CrossrefMedlineGoogle Scholar34. Daoud EG, Glotzer TV, Wyse DG, Ezekowitz MD, Hilker C, Koehler J, Ziegler PD; TRENDS Investigators. Temporal relationship of atrial tachyarrhythmias, cerebrovascular events, and systemic emboli based on stored device data: a subgroup analysis of TRENDS.Heart Rhythm. 2011; 8:1416–1423. doi: 10.1016/j.hrthm.2011.04.022.CrossrefMedlineGoogle Scholar35. Brambatti M, Connolly SJ, Gold MR, Morillo CA, Capucci A, Muto C, Lau CP, Van Gelder IC, Hohnloser SH, Carlson M, Fain E, Nakamya J, Mairesse GH, Halytska M, Deng WQ, Israel CW, Healey JS; ASSERT Investigators. Temporal relationship between subclinical atrial fibrillation and embolic events.Circulation. 2014; 129:2094–2099. doi: 10.1161/CIRCULATIONAHA.113.007825.LinkGoogle Scholar36. Martin DT.Randomized trial of anticoagulation guided by remote rhythm monitoring in patients with implanted cardioverter-defibrillator and resynchronization devices. ACC Scientific Session, Washington, DC, March2014.Google Scholar37. Camm AJ, Lip GY, De Caterina R, Savelieva I, Atar D, Hohnloser SH, Hindricks G, Kirchhof P; ESC Committee for Practice Guidelines (CPG). 2012 focused update of the ESC Guidelines for the management of atrial fibrillation: an update of the 2010 ESC Guidelines for the management of atrial fibrillation. Developed with the special contribution of the European Heart Rhythm Association.Eur Heart J. 2012; 33:2719–2747. doi: 10.1093/eurheartj/ehs253.CrossrefMedlineGoogle Scholar Previous Back to top Next FiguresReferencesRelatedDetails April 2015Vol 8, Issue 2 Advertisement Article InformationMetrics © 2015 American Heart Association, Inc.https://doi.org/10.1161/CIRCEP.115.002835PMID: 25900985 Originally publishedApril 1, 2015 Keywordsstrokeatrial fibrillationEditorialsPDF download Advertisement SubjectsCerebrovascular Disease/Stroke" @default.
• W2154667788 created "2016-06-24" @default.
• W2154667788 creator A5003719598 @default.
• W2154667788 date "2015-04-01" @default.
• W2154667788 modified "2023-09-25" @default.
• W2154667788 title "Asymptomatic Atrial Fibrillation After Cryptogenetic Stroke" @default.
• W2154667788 cites W1747765887 @default.
• W2154667788 cites W1974103997 @default.
• W2154667788 cites W1975186830 @default.
• W2154667788 cites W1981146424 @default.
• W2154667788 cites W1999468381 @default.
• W2154667788 cites W2000398770 @default.
• W2154667788 cites W2020006237 @default.
• W2154667788 cites W2024497977 @default.
• W2154667788 cites W2044480428 @default.
• W2154667788 cites W2058658939 @default.
• W2154667788 cites W2059551989 @default.
• W2154667788 cites W2065028337 @default.
• W2154667788 cites W2070314968 @default.
• W2154667788 cites W2075749661 @default.
• W2154667788 cites W2110571743 @default.
• W2154667788 cites W2111371826 @default.
• W2154667788 cites W2114775432 @default.
• W2154667788 cites W2121695173 @default.
• W2154667788 cites W2126416532 @default.
• W2154667788 cites W2129070819 @default.
• W2154667788 cites W2129906781 @default.
• W2154667788 cites W2130289969 @default.
• W2154667788 cites W2132505348 @default.
• W2154667788 cites W2140485936 @default.
• W2154667788 cites W2141889414 @default.
• W2154667788 cites W2145610874 @default.
• W2154667788 cites W2149989524 @default.
• W2154667788 cites W2152623033 @default.
• W2154667788 cites W2154658516 @default.
• W2154667788 cites W2163864813 @default.
• W2154667788 cites W2260482868 @default.
• W2154667788 cites W3030533492 @default.
• W2154667788 cites W4205645630 @default.
• W2154667788 doi "https://doi.org/10.1161/circep.115.002835" @default.
• W2154667788 hasPubMedId "https://pubmed.ncbi.nlm.nih.gov/25900985" @default.
• W2154667788 hasPublicationYear "2015" @default.
• W2154667788 type Work @default.
• W2154667788 sameAs 2154667788 @default.
• W2154667788 citedByCount "0" @default.
• W2154667788 crossrefType "journal-article" @default.
• W2154667788 hasAuthorship W2154667788A5003719598 @default.
• W2154667788 hasBestOaLocation W21546677881 @default.
• W2154667788 hasConcept C126322002 @default.
• W2154667788 hasConcept C127413603 @default.
• W2154667788 hasConcept C164705383 @default.
• W2154667788 hasConcept C2777910003 @default.
• W2154667788 hasConcept C2779161974 @default.
• W2154667788 hasConcept C2780645631 @default.
• W2154667788 hasConcept C71924100 @default.
• W2154667788 hasConcept C78519656 @default.
• W2154667788 hasConceptScore W2154667788C126322002 @default.
• W2154667788 hasConceptScore W2154667788C127413603 @default.
• W2154667788 hasConceptScore W2154667788C164705383 @default.
• W2154667788 hasConceptScore W2154667788C2777910003 @default.
• W2154667788 hasConceptScore W2154667788C2779161974 @default.
• W2154667788 hasConceptScore W2154667788C2780645631 @default.
• W2154667788 hasConceptScore W2154667788C71924100 @default.
• W2154667788 hasConceptScore W2154667788C78519656 @default.
• W2154667788 hasIssue "2" @default.
• W2154667788 hasLocation W21546677881 @default.
• W2154667788 hasLocation W21546677882 @default.
• W2154667788 hasOpenAccess W2154667788 @default.
• W2154667788 hasPrimaryLocation W21546677881 @default.
• W2154667788 hasRelatedWork W1980664993 @default.
• W2154667788 hasRelatedWork W2038078395 @default.
• W2154667788 hasRelatedWork W2127690875 @default.
• W2154667788 hasRelatedWork W2129906781 @default.
• W2154667788 hasRelatedWork W2272431884 @default.
• W2154667788 hasRelatedWork W2548594141 @default.
• W2154667788 hasRelatedWork W2763646354 @default.
• W2154667788 hasRelatedWork W3022950009 @default.
• W2154667788 hasRelatedWork W4236955258 @default.
• W2154667788 hasRelatedWork W2482122875 @default.
• W2154667788 hasVolume "8" @default.
• W2154667788 isParatext "false" @default.
• W2154667788 isRetracted "false" @default.
• W2154667788 magId "2154667788" @default.
• W2154667788 workType "article" @default.