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Early detection of occult atrial fibrillation and stroke prevention
  1. Joseph Walker Keach1,
  2. Steven M Bradley2,3,
  3. Mintu P Turakhia4,5,
  4. Thomas M Maddox2,3
  1. 1Department of Medicine, University of Colorado, Aurora, Colorado, USA
  2. 2Department of Cardiology, Veterans Affairs Eastern Colorado Health Care System, Denver, Colorado, USA
  3. 3Division of Cardiovascular Medicine, Department of Medicine, University of Colorado, Denver, Colorado, USA
  4. 4Department of Cardiology, Veterans Affairs Palo Alto Health Care System, Palo Alto, California, USA
  5. 5Division of Cardiovascular Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, California, USA
  1. Correspondence to Dr Thomas M Maddox, VA Eastern Colorado Healthcare System, 1055 Clermont Street, Mail Stop 111B, Denver, CO 80220, USA; thomas.maddox{at}va.gov

Abstract

Atrial fibrillation (AF) is a very common arrhythmia and significantly increases stroke risk. This risk can be mitigated with oral anticoagulation, but AF is often asymptomatic, or occult, preventing timely detection and treatment. Accordingly, occult AF may cause stroke before it is clinically diagnosed. Currently, guidelines for the early detection and treatment of occult AF are limited. This review addresses recent advancements in occult AF detection methods, identification of populations at high risk for occult AF, the treatment of occult AF with oral anticoagulation, as well as ongoing trials that may answer critically important questions regarding occult AF screening.

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