Subclinical Afib and HF; Hypertension Post-Stroke; Work Stress

Short episodes of subclinical atrial fibrillation that progress to longer episodes in patients with pacemakers or defibrillator devices may be a signal for heart failure trouble ahead, a study showed.

Episodes between 6 minutes and 24 hours in duration progressed to episodes lasting more than 24 hours or to clinical atrial fibrillation in about 9% of device patients per year and was independently associated with 4.58-fold greater risk of heart failure hospitalization, researchers reported in the Journal of the American College of Cardiology.

“This study is the first to demonstrate that progression of AF, even at its asymptomatic, subclinical stage, can be associated with adverse outcomes. As prior studies using implanted cardiac devices suggest that up to 85% of AF is not clinically recognized,” this subclinical subgroup “might benefit from preventive strategies.”

At the least, it should prompt lifestyle modification whenever possible, an accompanying editorial suggested.

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