PDF(Pubmed)
Abstract：
Atrial fibrillation (AF) carries a stroke risk, often necessitating anticoagulation, especially in patients with risk factors. With the advent of implantable and wearable heart monitors, episodes of short bouts of atrial arrhythmias called atrial high-rate episodes (AHREs) or subclinical AF (SCAF) are commonly identified. The necessity of anticoagulation in patients with SCAF is unclear. However, recent randomized controlled trials, the NOAH-AFNET 6 and ARTESIA, have offered insights into this matter. Furthermore, a study-level meta-analysis combining data from both these trials has provided more detailed information. Reviewing the information thus far, we can conclude that DOACs can result in a notable reduction in the risk of ischemic stroke and can potentially decrease the risk of debilitating stroke, albeit with an increased risk of major bleeding. Thus, informed, shared decision-making is essential, weighing the potential benefits of stroke prevention against the risk of major bleeding when considering anticoagulation in this patient population.
摘要：
心房颤动（AF）有中风的风险，通常需要抗凝，尤其是有危险因素的患者。随着可植入和可穿戴心脏监护仪的出现，短发性房性心律失常的发作称为心房高速率发作(AHRE)或亚临床AF(SCAF)。SCAF患者抗凝的必要性尚不清楚。然而,最近的随机对照试验，诺亚-AFNET6和艺术，提供了对这件事的见解。此外，一项研究水平的荟萃分析结合了这两项试验的数据,提供了更详细的信息.回顾到目前为止的信息，我们可以得出结论，DOAC可以显著降低缺血性卒中的风险，并可能降低衰弱性卒中的风险。尽管大出血的风险增加。因此，被告知,共同决策至关重要，在考虑对该患者人群进行抗凝治疗时,权衡卒中预防的潜在益处和大出血风险.
