No abstract

Atrial fibrillation (AF) is the most commonly encountered arrhythmia in clinical practice. Aging populations coupled with improved outcomes for many chronic medical conditions has led to increases in AF diagnoses. AF is also known to be associated with an increased risk of adverse events such as transient ischemic attack, ischemic stroke, systemic embolism, and death. This association is enhanced in select populations with preexisting comorbid conditions such as chronic heart failure. The aim of this review is to highlight the advances in the field of cardiology in the management of AF in both acute and long-term settings. We will also review the evolution of anticoagulation management over the past few years and landmark trials in the development of novel oral anticoagulants (NOACs), reversal agents for new NOACs, nonpharmacological options to anticoagulation therapy, and the role of implantable loop recorder in AF management.

Implantable loop recorders provide the highest sensitivity and accuracy of diagnosing cardiac arrhythmia that results in cardiac syncope. When bradyarrhythmia or tachyarrhythmia, including atrial fibrillation, is detected, appropriate secondary prevention therapy will be implemented, which will impact the long-term clinical outcome. An implantable loop recorder enables the clinician to record for a longer period of time, which increases the likelihood of detecting cardiac arrhythmia. Currently, this technology is being evaluated to diagnose a cardiac etiology of ischemic stroke and to optimize atrial fibrillation management that will predict the success of rhythm control and prevent thromboembolic events. This article reviews implantable loop recorder technology, and discusses the current indications, the outcomes of clinical studies and ongoing current studies, and future technological improvements.