Heart Podcast Anticoagulation in patients with low-burden atrial fibrillation: new evidence focusing on device-detected AF
Jan 27, 2026
Paulus Kirchhoff, professor of cardiology and electrophysiology from Hamburg, explains device-detected atrial fibrillation and why short, device-recorded episodes differ from ECG-diagnosed AF. He outlines why stroke risk is lower with device AF, how recent trials affect anticoagulation thinking, and which patients with vascular disease or higher AF burden might benefit from treatment.
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Author Background And Review Focus
- Paulus Kirchhoff is a cardiology professor at the University Heart and Vascular Center Hamburg with past posts in Birmingham and Münster.
- He led work on the review 'Anticoagulation in Patients with Low Burden Atrial Fibrillation.'
Device-Detected AF Is A Distinct Early Entity
- Device-detected AF are short, rare AF episodes found by implanted monitors that often never appear on a clinic ECG.
- These episodes represent an early or low-burden form of AF enabled by continuous monitoring.
Randomized Trials Show Lower-Than-Expected Stroke Risk
- Two 2023 randomized trials (NOAH-AFNET 6, ARTESIA) found much lower stroke rates without anticoagulation than expected.
- Anticoagulation produced a smaller relative stroke reduction and increased bleeding risk in this population.