ReviewJournal of clinical medicine2021
Comparing Outcomes in Asymptomatic and Symptomatic Atrial Fibrillation: A Systematic Review and Meta-Analysis of 81,462 Patients.
Review in Journal of clinical medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
32 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- [Update of the ESC atrial fibrillation guidelines : From the DGK commission for clinical cardiovascular medicine].Herzschrittmachertherapie & Elektrophysiologie · 2025Guideline
- The association between asthma and atrial fibrillation: systematic review and meta-analysis.Scientific reports · 2024Pooled it
- 2023 ACC/AHA/ACCP/HRS Guideline for the Diagnosis and Management of Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines.Journal of the American College of Cardiology · 2024Guideline
- Guideline
- Prevalence of atrial fibrillation and associated factors among adult cardiac patients at Ambo University Referral Hospital, West Shewa, Ethiopia, 2024/2025.American heart journal plus : cardiology research and practice · 2026Article
- Asymptomatic Atrial Fibrillation in Contemporary Clinical Practice: Insights from the REGUEIFA Registry.Medical sciences (Basel, Switzerland) · 2026Observational
- Cost-effectiveness of three screening strategies for atrial fibrillation in Sri Lanka: a decision-tree modelling analysis using community-based prevalence data.BMJ global health · 2026Article
- Long-Term Detection of Subclinical Atrial Fibrillation in Cryptogenic Stroke Patients With Insertable Cardiac Monitors.European journal of neurology · 2025Article
- Detection of Atrial Fibrillation in Holter ECG Recordings by ECHOView Images: A Deep Transfer Learning Study.Diagnostics (Basel, Switzerland) · 2025Article
- Article
- Wearables and Atrial Fibrillation: Advances in Detection, Clinical Impact, Ethical Concerns, and Future Perspectives.Cureus · 2025Review
- Spotlight on the 2024 ESC/EACTS management of atrial fibrillation guidelines: 10 novel key aspects.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2024Review
- Skin sympathetic nerve activity in symptomatic and asymptomatic paroxysmal atrial fibrillation.Heart rhythm · 2024Article
- Great debate: device-detected subclinical atrial fibrillation should be treated like clinical atrial fibrillation.European heart journal · 2024Article
- A danish healthcare-focused economic evaluation of first-line cryoballoon ablation versus antiarrhythmic drug therapy for the treatment of paroxysmal atrial fibrillation.BMC cardiovascular disorders · 2024Article
- Health-related quality of life and healthcare costs of symptoms and cardiovascular disease events in patients with atrial fibrillation: a longitudinal analysis of 27 countries from the EURObservational Research Programme on Atrial Fibrillation general long-term registry.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2024Observational
- Chinese Guidelines for the Diagnosis and Management of Atrial Fibrillation.Journal of geriatric cardiology : JGC · 2024Article
- Article
- Anticoagulation in Patients with Atrial High-rate Episodes Detected by Cardiac Implantable Electronic Devices.Current pharmaceutical design · 2024Review
- [Application of photoplethysmography for atrial fibrillation in early warning, diagnosis and integrated management].Sheng wu yi xue gong cheng xue za zhi = Journal of biomedical engineering = Shengwu yixue gongchengxue zazhi · 2023Review
Corrections and comments
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIn atrial fibrillation (AF) patients, the presence of symptoms can guide the decision between rate or rhythm control therapy, but it is still unclear if AF-related outcomes are determined by symptomatic status of their clinical presentation.
methodsWe performed a systematic review and metanalysis following the PRISMA recommendations on available studies that compared asymptomatic to symptomatic AF reporting data on all-cause mortality, cardiovascular death, and thromboembolic events (TEs). We included studies with a total number of patients enrolled equal to or greater than 200, with a minimum follow-up period of six months.
resultsFrom the initial 5476 results retrieved after duplicates' removal, a total of 10 studies were selected. Overall, 81,462 patients were included, of which 21,007 (26%) were asymptomatic, while 60,455 (74%) were symptomatic. No differences were found between symptomatic and asymptomatic patients regarding the risks of all-cause death (odds ratio (OR) 1.03, 95% confidence interval (CI) 0.81-1.32), and cardiovascular death (OR 0.87, 95% CI 0.54-1.39). No differences between symptomatic and asymptomatic groups were evident for stroke (OR 1.22, 95% CI 0.77-1.93) and stroke/TE (OR 1.06, 95% CI 0.86-1.31) risks.
conclusionsMortality and stroke/TE events in AF patients were unrelated to symptomatic status of their clinical presentation. Adoption of management strategies in AF patients should not be based on symptomatic clinical status.
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