When is Device-Detected Atrial Fibrillation Actionable?

Device-detected atrial high-rate episodes (AHREs) are frequently encountered in patients with no history of atrial fibrillation (AF) and represent a challenge for clinicians because patients with device-only documented AF have not been included in clinical trials of anticoagulants and other AF therapies. For patients with known history of AF, wireless continuous rhythm monitoring and rapidly acting oral anticoagulants offer the possibility of tailored anticoagulation in response to AHREs, with studies ongoing to evaluate the safety of this approach. This article provides an overview of current evidence on device-detected AHREs and evolving areas of investigation.