That Next AFib Patient with a CIED Will Need to Be Watched—Closely

While patients in the midst of atrial fibrillation may feel like they’re having a heart attack, most often their fears are unfounded. Often, an electrocardiogram to confirm there’s no imminent risk and a recommendation to follow up with their primary care provider or cardiologist are enough to put their fears to rest (which can actually be helpful in mitigating the episode). This doesn’t mean there’s no risk associated with AFib, of course. Causative factors need to be identified and addressed because recurring AFib is known to increase long-term risk for stroke. A new study published in JAMA Cardiology, however, raises a more significant red flag for AFib patients with cardiac implantable electronic devices (CIEDs). Researchers found that multihour AFib episodes raise the risk for stroke 3.7-fold for up to 30 days—with the highest risk period being the first 5 days of the episode. Patients who experience an AFib episode lasting 23 hours were at greatest risk for stroke. The findings should inform history-taking with patients presenting with symptoms of AFib, as well as recommendations to be vigilant over the coming days and to present for further care if necessary.