Subclinical atrial fibrillation in patients with cardiac implanted electronic devices

The subclinical atrial fi brillation (SCAF) in patients with cardiac implanted electronic devices (CIED) is a critical area of research in cardiology. It represents episodes of atrial fi brillation (AF) that occur in patients without any noticeable symptoms, registered by electronic devices for prolonged rhythm monitoring. Because of that, early diagnosis has proven to be diffi cult in the absence of advanced monitoring tools, such as smart electronic devices or implantable cardiac hardware. CIED, such as permanent pacemakers (PPM), implantable cardioverter defi brillators (ICD), resynchronization devices (CRT) and Loop Recorders (IRL) are fundamental in the detection of such episodes and provide continuous monitoring of the cardiac electrical activity. The early detections of SCAF provide the ability to initiate early prophylactic or therapeutic measurements that will help reduce not only the burden of disease, but also to reduce morbidity and mortality. The widespread use of CIED`s and wearable devices has led to the detection of subclinical AF in a signifi cant portion of the population. Thus, this detection may often help reduce the incidents of thromboembolism by initiating anticoagulation therapy. However, it is still unknown at what point and in which population long-term anticoagulation is benefi cial, having also in consideration the hemorrhagic risk. This review aims to explore the existing data and to identify the current gaps in knowledge.