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Oral anticoagulation for subclinical atrial tachyarrhythmias detected by implantable cardiac devices: an international survey of the AF-SCREEN Group

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Oral anticoagulation for subclinical atrial tachyarrhythmias detected by implantable cardiac devices: an international survey of the AF-SCREEN Group. / Boriani, Giuseppe; Healey, Jeff S; Schnabel, Renate B; Lopes, Renato D; Calkins, Hugh; Camm, John A; Freedman, Ben.

In: INT J CARDIOL, Vol. 296, 01.12.2019, p. 65-70.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Boriani, G, Healey, JS, Schnabel, RB, Lopes, RD, Calkins, H, Camm, JA & Freedman, B 2019, 'Oral anticoagulation for subclinical atrial tachyarrhythmias detected by implantable cardiac devices: an international survey of the AF-SCREEN Group', INT J CARDIOL, vol. 296, pp. 65-70. https://doi.org/10.1016/j.ijcard.2019.07.039

APA

Boriani, G., Healey, J. S., Schnabel, R. B., Lopes, R. D., Calkins, H., Camm, J. A., & Freedman, B. (2019). Oral anticoagulation for subclinical atrial tachyarrhythmias detected by implantable cardiac devices: an international survey of the AF-SCREEN Group. INT J CARDIOL, 296, 65-70. https://doi.org/10.1016/j.ijcard.2019.07.039

Vancouver

Boriani G, Healey JS, Schnabel RB, Lopes RD, Calkins H, Camm JA et al. Oral anticoagulation for subclinical atrial tachyarrhythmias detected by implantable cardiac devices: an international survey of the AF-SCREEN Group. INT J CARDIOL. 2019 Dec 1;296:65-70. https://doi.org/10.1016/j.ijcard.2019.07.039

Bibtex

@article{22650a074185441ca4fad01ea4f1f67d,
title = "Oral anticoagulation for subclinical atrial tachyarrhythmias detected by implantable cardiac devices: an international survey of the AF-SCREEN Group",
abstract = "AIMS: At present, there is little evidence on how to treat subclinical atrial fibrillation (SCAF) or atrial high rate episodes (AHREs) detected by cardiac implantable electronic devices (CIEDs). Our aim was to assess current practice around oral anticoagulation (OAC) in such patients.METHODS: A web-based survey undertaken by 310 physicians: 59 AF-SCREEN International Collaboration members and 251 non-members.RESULTS: In patients with SCAF/AHRE and a CHA2DS2VASc ≥ 2 in males or ≥ 3 in female the amount of SCAF/AHRE triggering use of OAC was variable but <2% of respondents considered that no AHRE would require OAC. Around one third (34%) considered SCAF/AHRE duration of >5-6 min as the basis for OAC prescription, while 16% and 18% required a burden of at least 5.5 h or 24 h, respectively. The propensity to prescribe OAC for a low burden of AHREs differed according to certain respondent characteristics (greater propensity to prescribe OAC for neurologists). When the clinical scenario included a prior stroke or a prior cardioembolic stroke, stated prescription of OAC was very high. More than 96% felt that any SCAF/AHRE should be treated with OAC.CONCLUSIONS: There is substantial heterogeneity in the perception of the risk of stroke/systemic embolism associated with SCAF/AHRE of variable duration. The threshold of AHRE burden that would trigger initiation of OAC is highly variable, and differs according to the clinical scenario (lower threshold in case of previous stroke). Ongoing trials will clarify the real benefit and risk/benefit ratio of OAC in this specific clinical setting.",
keywords = "Administration, Oral, Anticoagulants/administration & dosage, Asymptomatic Diseases, Defibrillators, Implantable, Female, Health Care Surveys, Humans, Internationality, Male, Practice Patterns, Physicians', Stroke/etiology, Tachycardia/complications",
author = "Giuseppe Boriani and Healey, {Jeff S} and Schnabel, {Renate B} and Lopes, {Renato D} and Hugh Calkins and Camm, {John A} and Ben Freedman",
note = "Copyright {\textcopyright} 2019 Elsevier B.V. All rights reserved.",
year = "2019",
month = dec,
day = "1",
doi = "10.1016/j.ijcard.2019.07.039",
language = "English",
volume = "296",
pages = "65--70",
journal = "INT J CARDIOL",
issn = "0167-5273",
publisher = "Elsevier Ireland Ltd",

}

RIS

TY - JOUR

T1 - Oral anticoagulation for subclinical atrial tachyarrhythmias detected by implantable cardiac devices: an international survey of the AF-SCREEN Group

AU - Boriani, Giuseppe

AU - Healey, Jeff S

AU - Schnabel, Renate B

AU - Lopes, Renato D

AU - Calkins, Hugh

AU - Camm, John A

AU - Freedman, Ben

N1 - Copyright © 2019 Elsevier B.V. All rights reserved.

PY - 2019/12/1

Y1 - 2019/12/1

N2 - AIMS: At present, there is little evidence on how to treat subclinical atrial fibrillation (SCAF) or atrial high rate episodes (AHREs) detected by cardiac implantable electronic devices (CIEDs). Our aim was to assess current practice around oral anticoagulation (OAC) in such patients.METHODS: A web-based survey undertaken by 310 physicians: 59 AF-SCREEN International Collaboration members and 251 non-members.RESULTS: In patients with SCAF/AHRE and a CHA2DS2VASc ≥ 2 in males or ≥ 3 in female the amount of SCAF/AHRE triggering use of OAC was variable but <2% of respondents considered that no AHRE would require OAC. Around one third (34%) considered SCAF/AHRE duration of >5-6 min as the basis for OAC prescription, while 16% and 18% required a burden of at least 5.5 h or 24 h, respectively. The propensity to prescribe OAC for a low burden of AHREs differed according to certain respondent characteristics (greater propensity to prescribe OAC for neurologists). When the clinical scenario included a prior stroke or a prior cardioembolic stroke, stated prescription of OAC was very high. More than 96% felt that any SCAF/AHRE should be treated with OAC.CONCLUSIONS: There is substantial heterogeneity in the perception of the risk of stroke/systemic embolism associated with SCAF/AHRE of variable duration. The threshold of AHRE burden that would trigger initiation of OAC is highly variable, and differs according to the clinical scenario (lower threshold in case of previous stroke). Ongoing trials will clarify the real benefit and risk/benefit ratio of OAC in this specific clinical setting.

AB - AIMS: At present, there is little evidence on how to treat subclinical atrial fibrillation (SCAF) or atrial high rate episodes (AHREs) detected by cardiac implantable electronic devices (CIEDs). Our aim was to assess current practice around oral anticoagulation (OAC) in such patients.METHODS: A web-based survey undertaken by 310 physicians: 59 AF-SCREEN International Collaboration members and 251 non-members.RESULTS: In patients with SCAF/AHRE and a CHA2DS2VASc ≥ 2 in males or ≥ 3 in female the amount of SCAF/AHRE triggering use of OAC was variable but <2% of respondents considered that no AHRE would require OAC. Around one third (34%) considered SCAF/AHRE duration of >5-6 min as the basis for OAC prescription, while 16% and 18% required a burden of at least 5.5 h or 24 h, respectively. The propensity to prescribe OAC for a low burden of AHREs differed according to certain respondent characteristics (greater propensity to prescribe OAC for neurologists). When the clinical scenario included a prior stroke or a prior cardioembolic stroke, stated prescription of OAC was very high. More than 96% felt that any SCAF/AHRE should be treated with OAC.CONCLUSIONS: There is substantial heterogeneity in the perception of the risk of stroke/systemic embolism associated with SCAF/AHRE of variable duration. The threshold of AHRE burden that would trigger initiation of OAC is highly variable, and differs according to the clinical scenario (lower threshold in case of previous stroke). Ongoing trials will clarify the real benefit and risk/benefit ratio of OAC in this specific clinical setting.

KW - Administration, Oral

KW - Anticoagulants/administration & dosage

KW - Asymptomatic Diseases

KW - Defibrillators, Implantable

KW - Female

KW - Health Care Surveys

KW - Humans

KW - Internationality

KW - Male

KW - Practice Patterns, Physicians'

KW - Stroke/etiology

KW - Tachycardia/complications

U2 - 10.1016/j.ijcard.2019.07.039

DO - 10.1016/j.ijcard.2019.07.039

M3 - SCORING: Journal article

C2 - 31327519

VL - 296

SP - 65

EP - 70

JO - INT J CARDIOL

JF - INT J CARDIOL

SN - 0167-5273

ER -