What Lies beneath the Surface — Treatment of Subclinical Atrial Fibrillation

Continuous heart rhythm monitoring with cardiac implantable devices has shown that atrial tachyarrhythmias, termed high-rate episodes (AHREs), occur in approximately one third of device carriers.1,2 AHRE definitions vary across studies, but cutoffs of an intracardiac atrial frequency of at least 180 bpm with a duration of 5 minutes or more is common.1 The terms subclinical atrial fibrillation and AHREs are sometimes used interchangeably, although subclinical atrial fibrillation encompasses asymptomatic atrial fibrillation detected by increasingly prevalent wearable devices.3,4 To ensure accuracy, the confirmation of arrhythmias by means of electrogram or electrocardiogram analysis is recommended.3 The risk of stroke in persons with . . .