Subclinical Atrial Fibrillation and the Risk of Stroke

• Published in: The New England journal of medicine Vol. 366; no. 14; pp. 1350 - 1353
• Main Authors: Wachter, Rolf, Stahrenberg, Raoul, Gröschel, Klaus, Wiesel, Joseph, Spinelli, Michael, Amato, James L, Haft, Jacob I, Chiti, Alberto, Orlandi, Giovanni, Bersohn, Malcolm M, Waldo, Albert L, Halperin, Jonathan L, Healey, Jeff S, Connolly, Stuart J, Hohnloser, Stefan H
• Format: Journal Article
• Language: English
• Published: United States Massachusetts Medical Society 05-04-2012
• Subjects: Atrial Fibrillation - complications; Cardiac arrhythmia; Defibrillators, Implantable; Electrocardiography; Embolism - etiology; Female; Fibrillation; Humans; Male; Pacemaker, Artificial; Stroke; Stroke - etiology
• ISSN: 0028-4793; 1533-4406
• DOI: 10.1056/NEJMc1201844

To the Editor:
In their article on the results of the Asymptomatic Atrial Fibrillation and Stroke Evaluation in Pacemaker Patients and the Atrial Fibrillation Reduction Atrial Pacing Trial (ASSERT; ClinicalTrials.gov number, NCT00256152), Healey et al. (Jan. 12 issue)
1
note that subclinical atrial fibrillation is believed to be a major cause of stroke of unknown cause, and their article supports this idea. We recently performed 7-day Holter monitoring in an unselected population of patients with stroke and found paroxysmal atrial fibrillation in 12.5% of all patients, but only 18% of strokes in patients with paroxysmal atrial fibrillation had been classified as . . .