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As is well known, the more you look for atrial fibrillation (AF), the more you will find it. This has been shown in studies with wearable and implanted devices. However, most episodes detected are short in duration, and anticoagulation has never been shown to reduce stroke risk with such incidentally identified AF. In The LOOP Study in Denmark, 6004 patients were randomized in a 1:3 ratio to receive an implantable loop recorder (ILR); the others received usual care. If AF >6 minutes in duration was found, anticoagulation was recommended. Participants did not have diagnosed AF, were 70 to 90 years old, and had at least one additional stroke risk factor.
During a median follow-up of 65 months, AF was diagnosed in 32% of the ILR group versus 12…