| Title |
Subklinikinis prieširdžių virpėjimas: insulto rizika, prieširdžių virpėjimo trukmės ir dažnio reikšmė bei klinikinės gydymo dilemos |
| Translation of Title |
Subclinical atrial fibrillation: stroke risk, significance of atrial fibrilation burden, and clinical management dilemmas. |
| Authors |
Vyšniauskaitė, Gabrielė Marija ; Vrublevski, Marcin |
| DOI |
10.53453/ms.2026.5.13 |
| Full Text |
|
| Is Part of |
Medicinos mokslai = Journal of medical science.. Kėdainiai : VšĮ Lietuvos sveikatos mokslinių tyrimų centras. 2026, vol. 14, iss. 3, p. 102-114.. eISSN 2345-0592 |
| Keywords [eng] |
subclinical atrial fibrillation ; stroke ; AF burden ; anticoagulation ; biomarkers ; artificial intelligence |
| Abstract [eng] |
Background. Subclinical atrial fibrillation (SCAF) is increasingly detected due to advances in continuous cardiac monitoring and wearable technologies. Although SCAF is associated with an elevated risk of stroke, this relationship is heterogeneous and largely dependent on atrial fibrillation burden (AF burden) and individual patient risk profiles. Clinical decision-making remains challenging due to the uncertain prognostic significance of short episodes and limited randomized evidence. Objective. To evaluate detection methods of SCAF, quantify its association with stroke risk, and analyze contemporary risk stratification and management strategies. Methods. A systematic literature review was conducted using PubMed, Scopus, and Cochrane Library databases. Randomized controlled trials, cohort studies, meta-analyses, and guidelines published between 2010 and 2024 were included. Keywords: subclinical atrial fibrillation, AHRE, AF burden, stroke risk, anticoagulation, wearable devices, biomarkers. Over 70 publications were analyzed. Results. SCAF is detected in up to 30-40% of patients undergoing long-term monitoring. Stroke risk increases approximately 2.0-2.5-fold, although absolute risk remains low (1-2% per year). AF burden is the strongest predictor: episodes >24 hours are associated with HR >3.0, whereas short episodes (<6 minutes) have limited clinical relevance. Randomized trials show that anticoagulation reduces stroke risk by ~30-40% but increases major bleeding. Emerging models integrating biomarkers and imaging parameters improve predictive accuracy (C-statistic up to 0.75). Conclusions. SCAF is a heterogeneous condition with an uncertain causal relationship to stroke. Management should be individualized, incorporating AF burden, clinical, and biological factors. Future strategies should focus on integrated, multidimensional risk models to optimize stroke prevention while minimizing overtreatment. |
| Published |
Kėdainiai : VšĮ Lietuvos sveikatos mokslinių tyrimų centras |
| Type |
Journal article |
| Language |
Lithuanian |
| Publication date |
2026 |
| CC license |
|
