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Asymptomatic Atrial Fibrillation & Stroke

One quarter of strokes are of unknown cause, and subclinical atrial fibrillation may be a common etiologic factor.
About 15% of strokes are attributable to documented atrial fibrillation, and 50 to 60% to documented cerebrovascular disease, but in about 25% of patients who have ischemic strokes, no etiologic factor is identified (cryptogenic stroke).
Subclinical atrial fibrillation is often suspected to be the cause of stroke in these patients. However, the prevalence and prognostic value of subclinical atrial fibrillation has been difficult to assess.

A recent recearch showed that among 2580 patients, who had implanted a Pacemaker or Defibrillator and had no history of atrial fibrllation, 261 (10.1%) of them showed subclinical atrial tachyarrhythmias detected by implanted devices in the first three months after implant; and these, with early occurrence of asymptomatic atrial tachyarrhythmias, had higher incidence of Stroke or systemic embolism (1.69%/year) compared to those without early occurrence of arrhythmias (0.69%/year).

Reference: NEJM Jan. 2012