Researchers Say Not All A-Fib Patients Need Anticoagulation

If episodes of atrial fibrillation are brief, risk of stroke is low
heart scan
heart scan

TUESDAY, Oct. 18, 2016 (HealthDay News) -- Some patients with atrial fibrillation who have implanted pacemakers or defibrillators may not always need anticoagulation, according to a study published online Oct. 17 in Circulation.

Steven Swiryn, M.D., a clinical professor of cardiology at the Feinberg School of Medicine at Northwestern University in Chicago, and colleagues looked at 37,531 electrograms from 5,379 patients over two years. All the participants took part in the RATE Registry (Registry of Atrial Tachycardia and Atrial Fibrillation Episodes), an ongoing study that follows patients with pacemakers or defibrillators.

The researchers found that patients who had only short bouts of atrial fibrillation -- estimated at 20 seconds or less -- were at no more risk for stroke or other cardiovascular complications than patients without atrial fibrillation.

"We knew that people with atrial fibrillation are at higher risk of stroke, but the next question was, how much atrial fibrillation?" Swiryn said in a news release from the American Heart Association. "Other studies have shown that prolonged episodes of atrial fibrillation pose a risk, but what about short ones? The answer until this study was 'no one knows.' Now we have good solid data that if all you have is short episodes of atrial fibrillation, the risk is so low that it doesn't warrant anticoagulants."

Several authors disclosed financial ties to pharmaceutical and medical device companies, including St. Jude Medical, which funded the RATE Registry.

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