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Can Implantable Cardiac Devices Be Used to Lower Risk of Stroke?

  • Arrhythmias (J. Bunch, Section Editor)
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Abstract

Purpose of Review

Implantable cardiac devices provide continuous heart rhythm monitoring. Device-detected atrial high rate episodes (AHREs) are commonly encountered; however, there is no consensus on how this information is best applied to prevention of stroke. This article provides an overview of the current literature on AHREs, stroke prevention, and evolving areas of investigation.

Recent Findings

AHREs predict increased thromboembolic risk at durations of 24 h or less. Shorter cutoffs have been less consistently associated with risk.

Summary

There is clinical equipoise for the use of oral anticoagulation for device-detected subclinical atrial fibrillation alone. Very short episodes may not require action beyond continued monitoring. Studies are ongoing to address the use of oral anticoagulation for device-detected subclinical AHREs alone, as well as tailored anticoagulation in response to AHREs in those with known history of AF.

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Authors and Affiliations

  1. Division of Cardiology, Northwestern University, Feinberg School of Medicine, 646 N. St. Clair, Suite 600, Chicago, IL, 60611, USA

    Jeremiah Wasserlauf

  2. Division of Cardiology, Northwestern University, Feinberg School of Medicine, 251 E Huron St, Suite 8-503, Chicago, IL, 60611, USA

    Rod S. Passman

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Correspondence to Rod S. Passman.

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J. Wasserlauf has no relevant disclosures. R. Passman received research support, consulting fees, and speaking fees from Medtronic, and received consulting fees and speaking fees from Biotronik.

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All reported studies/experiments with human or animal subjects performed by the authors have been previously published and complied with all applicable ethical standards (including the Helsinki declaration and its amendments, institutional/national research committee standards, and international/national/institutional guidelines).

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This article is part of the Topical Collection on Arrhythmias

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Wasserlauf, J., Passman, R.S. Can Implantable Cardiac Devices Be Used to Lower Risk of Stroke?. Curr Cardiovasc Risk Rep 11, 30 (2017). https://doi.org/10.1007/s12170-017-0554-5

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