Naseer Ahmad, Ayeesha Kamran Kamal.
Asymptomatic atrial fibrillation and stroke risk.
J Pak Med Assoc Jan ;64(3):362-362.

Asymptomatic Atrial Fibrillation: Why Should You Be Concerned? Atrial fibrillation (AF),is a well-established risk factor for thromboembolic events. Typical symptomatic presentation might include palpitations, dyspnoea, and fatigue. However, AF may be asymptomatic, and thus subclinical, causing no alarm to doctor or patient. Even in patients with documented symptomatic AF, asymptomatic recurrences are common. The first evidence of asymptomatic AF may be devastating: In the seminal Framingham study, among patients with stroke associated with AF, stroke was the first symptom of AF in 24%. Paroxysmal atrial fibrillation (PAF), as opposed to permanent AF, is transient, infrequent, and often asymptomatic.In fact, up to 90% of PAF episodes may be asymptomatic. This leads to delay in diagnosis. Most cardiologists would agree that PAF poses significant cardioembolic stroke risk meriting treatment. This begs the question, if diagnosis is delayed due to the asymptomatic nature of the disease, what can be done to diagnose this disease earlier? Additionally, are there precursor states to any form of AF that might also be key to early diagnosis and treatment?

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