Trial reportJournal of the American Heart Association2024
Anticoagulation in Patients With Device-Detected Atrial Fibrillation With and Without a Prior Stroke or Transient Ischemic Attack: The NOAH-AFNET 6 Trial.
Trial report in Journal of the American Heart Association, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 1 of them a synthesis that pooled it.
What it found
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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
19 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Anticoagulation in device-detected atrial fibrillation with or without vascular disease: a combined analysis of the NOAH-AFNET 6 and ARTESiA trials.European heart journal · 2024Pooled it
- Effects of anticoagulation in patients with device-detected atrial fibrillation and multiple stroke risk factors: a win ratio analysis of the NOAH-AFNET 6 trial.European heart journal. Quality of care & clinical outcomes · 2025Trial
- De-risking Atrial Fibrillation: Refining Anticoagulation Decision-Making.American journal of cardiovascular drugs : drugs, devices, and other interventions · 2026Review
- Atrial fibrillation detected after stroke: Recent advances and future directions.International journal of stroke : official journal of the International Stroke Society · 2026Review
- Cost-Effectiveness of Anticoagulation Treatment for Subclinical Device-Detected Atrial Fibrillation.JAMA network open · 2026Article
- Direct-to-Participant Enrollment in a Virtual Trial: Lessons Learned From the Heartline Study.JACC. Advances · 2026Article
- The Brain-Atrial Fibrillation-Recent Rehabilitation Axis: A Modern Approach.Healthcare (Basel, Switzerland) · 2026Review
- [What to do with device-detected atrial fibrillation? : Executive summary of the position paper of the German Society of Cardiology].Herzschrittmachertherapie & Elektrophysiologie · 2026Review
- Machine learning-based prediction of atrial fibrillation in patients with atrial high-rate episodes.European journal of clinical investigation · 2026Article
- From Detection to Decision: Managing Device-Detected Atrial Fibrillation After Stroke.Current neurology and neuroscience reports · 2025Review
- Cryptogenic stroke: definitions and management.Hematology. American Society of Hematology. Education Program · 2025Review
- Review
- Estimating the Stroke Risk Threshold for Initiating Non-Vitamin K Antagonist Oral Anticoagulation in Atrial Fibrillation: Markov Decision Model Analysis.Circulation. Cardiovascular quality and outcomes · 2025Article
- Baseline characteristics of patients with acute ischaemic stroke included in the randomised controlled Find-AF 2 trial.Neurological research and practice · 2025Article
- Net Benefit of Anticoagulation in Subclinical Device-Detected Atrial Fibrillation.JAMA network open · 2025Article
- Evolution in electrophysiology 100 years after Einthoven: translational and computational innovations in rhythm control of atrial fibrillation.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
- Article
- Device-Detected Atrial Fibrillation and the Impact of Prior Stroke in Stroke Prevention.Journal of the American Heart Association · 2024Article
- Discrepant Outcomes of Direct Oral Anticoagulant Trials in Device-Detected Atrial Fibrillation after Stroke: Insights from NOAH-AFNET 6 and ARTESIA.Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/HemostasisReview
Corrections and comments
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Authors and funding
35 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundShort and rare episodes of atrial fibrillation (AF) are commonly detected using implanted devices (device-detected AF) in patients with prior stroke or transient ischemic attack (TIA). The effectiveness and safety of oral anticoagulation in patients with prior stroke or TIA and device-detected AF but with no ECG-documented AF is unclear. METHODS AND
resultsThis prespecified analysis of the NOAH-AFNET 6 (Non-Vitamin K Antagonist Oral Anticoagulants in Patients With Atrial High Rate Episodes) trial with post hoc elements assessed the effect of oral anticoagulation in patients with device-detected AF with and without a prior stroke or TIA in the randomized, double-blind, double-dummy NOAH-AFNET 6 trial. Outcomes were stroke, systemic embolism, and cardiovascular death (primary outcome) and major bleeding and death (safety outcome). A prior stroke or TIA was found in 253 patients with device-detected AF randomized in the NOAH-AFNET 6 (mean age, 78 years; 36.4% women). There was no treatment interaction with prior stroke or TIA for any of the primary and secondary time-to-event outcomes. In patients with a prior stroke or TIA, 14 out of 122 patients experienced a primary outcome event with anticoagulation (5.7% per patient-year). Without anticoagulation, there were 16 out of 131 patients with an event (6.3% per patient-year). The rate of stroke was lower than expected (anticoagulation: 4 out of 122 [1.6% per patient-year]; no anticoagulation: 6 out of 131 [2.3% per patient-year]). Numerically, there were more major bleeding events with anticoagulation in patients with prior stroke or TIA (8 out of 122 patients) than without anticoagulation (2 out of 131 patients).
conclusionsAnticoagulation appears to have ambiguous effects in patients with device-detected AF and a prior stroke or TIA in this hypothesis-generating analysis of the NOAH-AFNET 6 in the absence of ECG-documented AF, partially due to a low rate of stroke without anticoagulation.
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