亚临床心房颤动的研究进展
Research Progress of Subclinical Atrial Fibrillation
DOI: 10.12677/acm.2025.1551445, PDF,   
作者: 陶光泓, 肖 骅*：重庆医科大学附属第一医院心血管内科(心血管研究中心)，重庆
关键词: 亚临床心房颤动；抗凝治疗；植入型电子装置；卒中；Subclinical Atrial Fibrillation； Anticoagulation Therapy； Implantable Electronic Device； Stroke
摘要: 亚临床心房颤动在具有心内植入型电子装置的患者中检出率很高。随着监测设备的发展，亚临床心房颤动得到了进一步的认识和重视。但目前关于亚临床心房颤动的诊断以及此类患者的管理仍存在分歧。本文总结了目前有关亚临床心房颤动的研究进展，为该病的诊治提供依据。
Abstract: The detection rate of subclinical atrial fibrillation is very high in patients with intracardiac implantable electronic devices. With the development of monitoring equipment, subclinical atrial fibrillation has been further recognized and valued. However, there are still differences in the diagnosis of subclinical atrial fibrillation and the management of such patients. This paper summarizes the research progress of subclinical atrial fibrillation at present, and provides a basis for the diagnosis and treatment of this disease.
文章引用：陶光泓, 肖骅. 亚临床心房颤动的研究进展[J]. 临床医学进展, 2025, 15(5): 876-881. https://doi.org/10.12677/acm.2025.1551445

参考文献

[1] Freedman, B., Boriani, G., Glotzer, T.V., Healey, J.S., Kirchhof, P. and Potpara, T.S. (2017) Management of Atrial High-Rate Episodes Detected by Cardiac Implanted Electronic Devices. Nature Reviews Cardiology, 14, 701-714. [Google Scholar] [CrossRef] [PubMed]
[2] Chiti, A. and Orlandi, G. (2012) Subclinical Atrial Fibrillation and the Risk of Stroke. New England Journal of Medicine, 366, 1351-1353.
[3] Bertaglia, E., Blank, B., Blomström-Lundqvist, C., Brandes, A., Cabanelas, N., et al. (2019) Atrial High-Rate Episodes: Prevalence, Stroke Risk, Implications for Management, and Clinical Gaps in Evidence. EP Europace, 21, 1459-1467. [Google Scholar] [CrossRef] [PubMed]
[4] Proietti, M., Romiti, G.F., Vitolo, M., Borgi, M., Rocco, A.D., Farcomeni, A., et al. (2022) Epidemiology of Subclinical Atrial Fibrillation in Patients with Cardiac Implantable Electronic Devices: A Systematic Review and Meta-Regression. European Journal of Internal Medicine, 103, 84-94. [Google Scholar] [CrossRef] [PubMed]
[5] Jiang, J., Mi, L., Chen, K., Hua, W., Su, Y., Xu, W., et al. (2024) Association of Device-Detected Atrial High-Rate Episodes with Long-Term Cardiovascular and All-Cause Mortality: A Cohort Study. Canadian Journal of Cardiology, 40, 598-607. [Google Scholar] [CrossRef] [PubMed]
[6] Allam, L.E., Moneim, Y.A., Eldamanhoury, H.M. and Eltoukhy, S.M.A. (2025) Effect of Atrial High-Rate Episodes (AHREs) on Functional Status and Quality of Life (QoL) in Heart Failure—Cardiac Resynchronization Therapy Population. The Egyptian Heart Journal, 77, Article No. 19. [Google Scholar] [CrossRef] [PubMed]
[7] Olsen, F.J., Diederichsen, S.Z., Jørgensen, P.G., Jensen, M.T., Dahl, A., Landler, N.E., et al. (2024) Left Atrial Strain Predicts Subclinical Atrial Fibrillation Detected by Long-Term Continuous Monitoring in Elderly High-Risk Individuals. Circulation: Cardiovascular Imaging, 17, e016197. [Google Scholar] [CrossRef] [PubMed]
[8] Glotzer, T.V., Hellkamp, A.S., Zimmerman, J., Sweeney, M.O., Yee, R., Marinchak, R., et al. (2003) Atrial High Rate Episodes Detected by Pacemaker Diagnostics Predict Death and Stroke: Report of the Atrial Diagnostics Ancillary Study of the MOde Selection Trial (MOST). Circulation, 107, 1614-1619. [Google Scholar] [CrossRef] [PubMed]
[9] Glotzer, T.V., Daoud, E.G., Wyse, D.G., Singer, D.E., Ezekowitz, M.D., Hilker, C., et al. (2009) The Relationship between Daily Atrial Tachyarrhythmia Burden from Implantable Device Diagnostics and Stroke Risk: The TRENDS Study. Circulation: Arrhythmia and Electrophysiology, 2, 474-480. [Google Scholar] [CrossRef] [PubMed]
[10] Boriani, G., Glotzer, T.V., Santini, M., West, T.M., De Melis, M., Sepsi, M., et al. (2013) Device-Detected Atrial Fibrillation and Risk for Stroke: An Analysis of >10 000 Patients from the SOS AF Project (Stroke Prevention Strategies Based on Atrial Fibrillation Information from Implanted Devices). European Heart Journal, 35, 508-516. [Google Scholar] [CrossRef] [PubMed]
[11] Van Gelder, I.C., Healey, J.S., Crijns, H.J.G.M., Wang, J., Hohnloser, S.H., Gold, M.R., et al. (2017) Duration of Device-Detected Subclinical Atrial Fibrillation and Occurrence of Stroke in ASSERT. European Heart Journal, 38, 1339-1344. [Google Scholar] [CrossRef] [PubMed]
[12] Healey, J.S., Alings, M., Ha, A., Leong-Sit, P., Birnie, D.H., de Graaf, J.J., et al. (2017) Subclinical Atrial Fibrillation in Older Patients. Circulation, 136, 1276-1283. [Google Scholar] [CrossRef] [PubMed]
[13] Svennberg, E., Friberg, L., Frykman, V., Al-Khalili, F., Engdahl, J. and Rosenqvist, M. (2021) Clinical Outcomes in Systematic Screening for Atrial Fibrillation (STROKESTOP): A Multicentre, Parallel Group, Unmasked, Randomised Controlled Trial. The Lancet, 398, 1498-1506. [Google Scholar] [CrossRef] [PubMed]
[14] Diederichsen, S.Z., Haugan, K.J., Brandes, A., Lanng, M.B., Graff, C., Krieger, D., et al. (2019) Natural History of Subclinical Atrial Fibrillation Detected by Implanted Loop Recorders. Journal of the American College of Cardiology, 74, 2771-2781. [Google Scholar] [CrossRef] [PubMed]
[15] Wattanachayakul, P., Yanpiset, P., Kulthamrongsri, N., Prasitsumrit, V., Lo, K.B., Kewcharoen, J., et al. (2025) Prognostic Values of Atrial High-Rate Episodes on Mortality Risks in CIED Patients. Journal of Cardiology. [Google Scholar] [CrossRef] [PubMed]
[16] Martin, D.T., Bersohn, M.M., Waldo, A.L., Wathen, M.S., Choucair, W.K., Lip, G.Y.H., et al. (2015) Randomized Trial of Atrial Arrhythmia Monitoring to Guide Anticoagulation in Patients with Implanted Defibrillator and Cardiac Resynchronization Devices. European Heart Journal, 36, 1660-1668. [Google Scholar] [CrossRef] [PubMed]
[17] Kirchhof, P., Toennis, T., Goette, A., Camm, A.J., Diener, H.C., Becher, N., et al. (2023) Anticoagulation with Edoxaban in Patients with Atrial High-Rate Episodes. New England Journal of Medicine, 389, 1167-1179. [Google Scholar] [CrossRef] [PubMed]
[18] Healey, J.S., Lopes, R.D., Granger, C.B., Alings, M., Rivard, L., McIntyre, W.F., et al. (2024) Apixaban for Stroke Prevention in Subclinical Atrial Fibrillation. New England Journal of Medicine, 390, 107-117. [Google Scholar] [CrossRef] [PubMed]
[19] Lopes, R.D., Granger, C.B., Wojdyla, D.M., McIntyre, W.F., Alings, M., Mani, T., et al. (2024) Apixaban vs Aspirin According to CHA(2)DS(2)-VASc Score in Subclinical Atrial Fibrillation: Insights from ARTESiA. Journal of the American College of Cardiology, 84, 354-364. [Google Scholar] [CrossRef] [PubMed]
[20] Shoamanesh, A., Field, T.S., Coutts, S.B., Sharma, M., Gladstone, D., Hart, R.G., et al. (2025) Apixaban versus Aspirin for Stroke Prevention in People with Subclinical Atrial Fibrillation and a History of Stroke or Transient Ischaemic Attack: Subgroup Analysis of the ARTESiA Randomised Controlled Trial. The Lancet Neurology, 24, 140-151. [Google Scholar] [CrossRef] [PubMed]
[21] McIntyre, W.F., Benz, A.P., Becher, N., Healey, J.S., Granger, C.B., Rivard, L., et al. (2024) Direct Oral Anticoagulants for Stroke Prevention in Patients with Device-Detected Atrial Fibrillation: A Study-Level Meta-Analysis of the NOAH-AFNET 6 and ARTESiA Trials. Circulation, 149, 981-988. [Google Scholar] [CrossRef] [PubMed]
[22] Becher, N., Toennis, T., Bertaglia, E., Blomström-Lundqvist, C., Brandes, A., Cabanelas, N., et al. (2023) Anticoagulation with Edoxaban in Patients with Long Atrial High-Rate Episodes ≥ 24 H. European Heart Journal, 45, 837-849. [Google Scholar] [CrossRef] [PubMed]
[23] McIntyre, W.F., Benz, A.P., Healey, J.S., Connolly, S.J., Yang, M., Lee, S.F., et al. (2024) Risk of Stroke or Systemic Embolism According to Baseline Frequency and Duration of Subclinical Atrial Fibrillation: Insights from the ARTESiA Trial. Circulation, 150, 1747-1755. [Google Scholar] [CrossRef] [PubMed]

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