Silent atrial fibrillation: epidemiology, diagnosis and treatment

Chairmen : Shinichi Niwano (Kitasato University School of Medicine)
Jonathan M. Kalman (University of Melbourne, Royal Melbourne Hospital)

The attention to the atrial fibrillation (AF) is getting bigger and bigger every year because of its incidence in general population as well as the impact of thrombo-embolic events resulted from the left atrial thrombi. By considering more effective rhythm therapy using catheter ablation technique and primary prevention of cerebral infarction using DOACs, earlier detection of AF has become important issue in clinical management of AF. Additionally, because various tools for AF detection, such as internal loop recorder, 1-2 week Holter recording, and remote monitoring using implanted cardiac devices, became popular in nowadays, “silent” AF might be detected in much larger population than before. However, we have to notice that our present understanding of AF therapy is basing on the conventional diagnosis of AF using regular method, such as repeated 12-lead ECG, event recorder as well as regular (24-hour) Holter monitoring. Nobody knows yet the clinical importance of asymptomatic, shorter, and less frequent AF, and an appropriate management of such “new type” category of arrhythmia should be discussed separately from conventional AF basing on various data of “silent” AF. In this symposium, the importance, i.e., epidemiology, diagnosis and treatment, of silent AF will be discussed by several distinguished experts concerning this problem.