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Two large studies published in 2023 shed light on management of subclinical atrial fibrillation (AF) — asymptomatic, brief episodes of AF that usually are detected by interrogation of implanted devices, such as pacemakers and cardioverter-defibrillators, and are associated with excess risk for stroke.
In the NOAH-AFnet study, investigators enrolled about 2600 older patients (age, ≥65; mean age, 78; median CHA2DS2-VASc score, 4) who had high-rate episodes of at least 6 minutes' duration detected by implanted devices and had at least one risk factor for stroke; patients were randomized to either edoxaban or placebo. After early termination due to safety and futility concerns, the primary outcome (i.e., cardiovascular-related death, stroke, or …