Reader's Comments: Beyond Atrial Fibrillation Patterns as Contributors to Risk of Thromboembolism

I read with great interest the paper by Zhang et al1 in which the authors reported that the incidence of stroke and systemic embolism and overall mortality were lower in paroxysmal atrial fibrillation (AF) than in persistent or permanent AF while annualized major bleeding rates were similar across AF types. In truth, this is not a new observation. Ganesan et al2 reported essentially the same findings in 2016, as have others.3 Importantly, Zhang et al1 noted that both the CHADS2 and CHA2DS2-VASc risk scoring systems do not consider the type of AF, which may be a significant limitation in their utility if AF type is truly important in conferring risk, and that AF burden (the percent of time one is in AF), which correlates positively with the stroke risk in un-anticoagulated patients, is lower in paroxysmal AF than in nonparoxysmal forms.
Source: The American Journal of Cardiology - Category: Cardiology Authors: Source Type: research