Xavier Scheuermeyer F, Grafstein E, Stenstrom R, Innes G, Poureslami I, Sighary M. Thirty-day outcomes of emergency department patients undergoing electrical cardioversion for atrial brillation or utter. Acad Emerg Med. 2010;17(4):408-415. 273. Jaakkola S, Lip GY, Biancari F, et al. Predicting Unsuccessful Electrical Cardioversion for Acute Atrial Fibrillation (from the AF- CVS Score). Am J Cardiol. 2016. 274. Arnold AZ, Mick MJ, Mazurek RP, Loop FD, Trohman RG. Role of prophylactic anticoagulation for direct current cardioversion in patients with atrial brillation or atrial utter. J Am Coll Cardiol. 1992;19(4):851-855. 275. Chalasani P, Cambre S, Silverman ME. Direct-current cardioversion for the conversion of atrial utter. Am J Cardiol. 1996;77(8):658-660. 276. Basili S, Loffredo L, Pastori D, et al. Carotid plaque detection improves the predictive value of CHA2DS2-VASc score in patients with non-valvular atrial brillation: the ARAPACIS Study. Int J Cardiol. 2017;231:143-149. 277. Lip GYH, Collet JP, Haude M, et al. 2018 Joint European consensus document on the management of antithrombotic therapy in atrial brillation patients presenting with acute coronary syndrome and/ or undergoing percutaneous cardiovascular interventions: A joint consensus document of the European Heart Rhythm Association (EHRA), European Society of Cardiology Working Group on Thrombosis, European Association of Percutaneous Cardiovascular Interventions (EAPCI) and European Association of Acute Cardiac Care (ACCA) endorsed by the Heart Rhythm Society (HRS), Asia- Paci c Heart Rhythm Society (APHRS), Latin America Heart Rhythm Society (LAHRS) and Cardiac Arrhythmia Society of Southern Africa (CASSA) [published online ahead of print July 21, 2018]. Europace. https://doi.org/10.1093/europace/euy174. 278. Bonaca MP, Goto S, Bhatt DL, et al. Prevention of stroke with ticagrelor in patients with prior myocardial infarction: insights from PEGASUS-TIMI 54 (Prevention of Cardiovascular Events in Patients With Prior Heart Attack Using Ticagrelor Compared to Placebo on a Background of Aspirin-Thrombolysis in Myocardial Infarction 54). (1524-4539 (Electronic)). 279. Proietti M, Airaksinen KEJ, Rubboli A, et al. Time in therapeutic range and major adverse outcomes in atrial brillation patients undergoing percutaneous coronary intervention: the Atrial Fibrillation Undergoing Coronary Artery Stenting (AFCAS) registry. Am Heart J. 2017;190:86-93. 280. Chaudhary N, Bundhun PK, Yan H. Comparing the clinical outcomes in patients with atrial brillation receiving dual antiplatelet therapy and patients receiving an addition of an anticoagulant after coronary stent implantation: a systematic review and meta-analysis of observational studies. Medicine (Baltimore). 2016;95(50):e5581. 281. Zhu W, Guo L, Liu F, et al. Ef cacy and safety of triple versus dual antithrombotic therapy in atrial brillation and ischemic heart disease: a systematic review and meta-analysis. Oncotarget. 2017;8(46):81154-81166. 282. Bennaghmouch N, de Veer AJWM, Bode K, et al. Ef cacy and safety of the use of non-vitamin K antagonist oral anticoagulants in patients with nonvalvular atrial brillation and concomitant aspirin therapy: a meta-analysis of randomized trials. Circulation. 2018;137(11):1117-1129. 283. Lamberts M, Gislason GH, Olesen JB, et al. Oral anticoagulation and antiplatelets in atrial brillation patients after myocardial infarction and coronary intervention. J Am Coll Cardiol. 2013;62(11):981-989. 284. Dewilde WJ, Oirbans T, Verheugt FW, et al. Use of clopidogrel with or without aspirin in patients taking oral anticoagulant therapy and undergoing percutaneous coronary intervention: an open-label, randomised, controlled trial. Lancet. 2013;381(9872): 1107-1115. 285. Fiedler KA, Maeng M, Mehilli J, et al. Duration of triple therapy in patients requiring oral anticoagulation after drug-eluting stent implantation: the ISAR-TRIPLE Trial. J Am Coll Cardiol. 2015;65(16):1619-1629. 286. Gibson CM, Mehran R, Bode C, et al. Prevention of bleeding in patients with atrial brillation undergoing PCI. N Engl J Med. 2016;375(25):2423-2434. 287. Gibson CM, Pinto DS, Chi G, et al. Recurrent hospitalization among patients with atrial brillation undergoing intracoronary stenting treated with 2 treatment strategies of rivaroxaban or a dose-adjusted oral vitamin K antagonist treatment strategy. Circulation. 2017;135(4):323-333. 288. Cannon CP, Bhatt DL, Oldgren J, et al. Dual antithrombotic therapy with dabigatran after PCI in atrial brillation. N Engl J Med. 2017;377(16):1513-1524. 289. Sarafoff N, Martischnig A, Wealer J, et al. Triple therapy with aspirin, prasugrel, and vitamin K antagonists in patients with drug- eluting stent implantation and an indication for oral anticoagulation. J Am Coll Cardiol. 2013;61(20):2060-2066. 290. Ohman EM, Roe MT, Steg PG, et al. Clinically signi cant bleeding with low-dose rivaroxaban versus aspirin, in addition to P2Y12 inhibition, in acute coronary syndromes (GEMINI-ACS-1): a double-blind, multicentre, randomised trial. Lancet. 2017. 291. Nielsen PB, Skjoth F, Rasmussen LH, Larsen TB, Lip GY. Using the CHA2DS2-VASc score for stroke prevention in atrial brillation: a focus on vascular disease, women, and simple practical application. Can J Cardiol. 2015;31(6):820.e9-820.e10. 292. Lin LY, Lee CH, Yu CC, et al. Risk factors and incidence of ischemic stroke in Taiwanese with nonvalvular atrial brillation a nation wide database analysis. Atherosclerosis. 2011;217(1):292-295. 293. Lamberts M, Gislason GH, Lip GY, et al. Antiplatelet therapy for stable coronary artery disease in atrial brillation patients taking an oral anticoagulant: a nationwide cohort study. Circulation. 2014;129(15):1577-1585. 294. Kumar S, Danik SB, Altman RK, et al. Non-vitamin K antagonist oral anticoagulants and antiplatelet therapy for stroke prevention in patients with atrial brillation: a meta-analysis of randomized controlled trials. Cardiol Rev. 2016;24(5):218-223. 295. Dans AL, Connolly SJ, Wallentin L, et al. Concomitant use of antiplatelet therapy with dabigatran or warfarin in the Randomized Evaluation of Long-Term Anticoagulation Therapy (RE-LY) trial. Circulation. 2013;127(5):634-640. 296. Jones WS, Hellkamp AS, Halperin J, et al. Ef cacy and safety of rivaroxaban compared with warfarin in patients with peripheral artery disease and non-valvular atrial brillation: insights from ROCKET AF. Eur Heart J. 2014;35(4):242-249. 297. Calkins H, Hindricks G, Cappato R, et al. 2017 HRS/EHRA/ECAS/ APHRS/SOLAECE expert consensus statement on catheter and surgical ablation of atrial brillation. Europace. 2018;20(1):e1-e160. 298. Di Biase L, Burkhardt JD, Santangeli P, et al. Periprocedural stroke and bleeding complications in patients undergoing catheter ablation of atrial brillation with different anticoagulation management: results from the Role of Coumadin in Preventing Thromboembolism in Atrial Fibrillation (AF) Patients Undergoing Catheter Ablation (COMPARE) randomized trial. Circulation. 2014;129(25):2638-2644. 299. Cappato R, Marchlinski FE, Hohnloser SH, et al. Uninterrupted rivaroxaban vs. uninterrupted vitamin K antagonists for catheter ablation in non-valvular atrial brillation. Eur Heart J. 2015;36(28): 1805-1811. 300. Calkins H, Willems S, Gerstenfeld EP, et al. Uninterrupted dabigatran versus warfarin for ablation in atrial brillation. N Engl J Med. 2017;376(17):1627-1636. 301. Essebag V, Healey JS, Ayala-Paredes F, et al. Strategy of continued vs interrupted novel oral anticoagulant at time of device surgery in patients with moderate to high risk of arterial thromboembolic events: the BRUISE CONTROL-2 trial. Am Heart J. 2016;173:102- 107. 1196 Evidence-Based Medicine [ 1 5 4 # 5 C H E S T N O V E M B E R 2 0 1 8 ] 302. Cardoso R, Knijnik L, Bhonsale A, et al. An updated meta-analysis of novel oral anticoagulants versus vitamin K antagonists for uninterrupted anticoagulation in atrial brillation catheter ablation. Heart Rhythm. 2018;15(1):107-115. 303. Nairooz R, Ayoub K, Sardar P, et al. Uninterrupted new oral anticoagulants compared with uninterrupted vitamin K antagonists in ablation of atrial brillation: a meta-analysis. Can J Cardiol. 2016;32(6):814-823. 304. Daoud EG, Glotzer TV, Wyse DG, et al. Temporal relationship of atrial tachyarrhythmias, cerebrovascular events, and systemic emboli based on stored device data: a subgroup analysis of TRENDS. Heart Rhythm. 2011;8(9):1416-1423. 305. Brambatti M, Connolly SJ, Gold MR, et al. Temporal relationship between subclinical atrial brillation and embolic events. Circulation. 2014;129(21):2094-2099. 306. Gialdini G, Nearing K, Bhave PD, et al. Perioperative atrial brillation and the long-term risk of ischemic stroke. JAMA. 2014;312(6):616-622. 307. Saxena R, Lewis S, Berge E, Sandercock PA, Koudstaal PJ. Risk of early death and recurrent stroke and effect of heparin in 3169 patients with acute ischemic stroke and atrial brillation in the International Stroke Trial. Stroke. 2001;32(10):2333-2337. 308. Hart RG, Coull BM, Hart D. Early recurrent embolism associated with nonvalvular atrial brillation: a retrospective study. Stroke. 1983;14(5):688-693. 309. Berge E, Abdelnoor M, Nakstad PH, Sandset PM. Low molecular- weight heparin versus aspirin in patients with acute ischaemic stroke and atrial brillation: a double-blind randomised study. HAEST Study Group. Heparin in Acute Embolic Stroke Trial. Lancet. 2000;355(9211):1205-1210. 310. Paciaroni M, Agnelli G, Micheli S, Caso V. Ef cacy and safety of anticoagulant treatment in acute cardioembolic stroke: a meta- analysis of randomized controlled trials. Stroke. 2007;38(2):423- 430. 311. CAST: randomised placebo-controlled trial of early aspirin use in 20,000 patients with acute ischaemic stroke. CAST (Chinese Acute Stroke Trial) Collaborative Group. Lancet. 1997;349(9066):1641- 1649. 312. Lin HJ, Wolf PA, Kelly-Hayes M, et al. Stroke severity in atrial brillation. The Framingham Study. Stroke. 1996;27(10):1760-1764. 313. Paciaroni M, Agnelli G, Corea F, et al. Early hemorrhagic transformation of brain infarction: rate, predictive factors, and in uence on clinical outcome: results of a prospective multicenter study. Stroke. 2008;39(8):2249-2256. 314. Paciaroni M, Agnelli G, Falocci N, et al. Early recurrence and cerebral bleeding in patients with acute ischemic stroke and atrial brillation: effect of anticoagulation and its timing: the RAF Study. Stroke. 2015;46(8):2175-2182. 315. Abdul-Rahim AH, Fulton RL, Frank B, et al. Association of improved outcome in acute ischaemic stroke patients with atrial brillation who receive early antithrombotic therapy: analysis from VISTA. Eur J Neurol. 2015;22(7):1048-1055. 316. Kernan WN, Ovbiagele B, Black HR, et al. Guidelines for the prevention of stroke in patients with stroke and transient ischemic attack: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2014;45(7): 2160-2236. 317. Kirchhof P, Benussi S, Kotecha D, et al. 2016 ESC Guidelines for the management of atrial brillation developed in collaboration with EACTS [in Polish]. Kardiol Pol. 2016;74(12):1359-1469. 318. Paciaroni M, Agnelli G, Ageno W, Caso V. Timing of anticoagulation therapy in patients with acute ischaemic stroke and atrial brillation. Thromb Haemost. 2016;116(3):410-416. 319. Palm F, Kraus M, Safer A, Wolf J, Becher H, Grau AJ. Management of oral anticoagulation after cardioembolic stroke and stroke survival data from a population based stroke registry (LuSSt). BMC neurology. 2014;14:199. 320. Chamorro A, Vila N, Ascaso C, Blanc R. Heparin in acute stroke with atrial brillation: clinical relevance of very early treatment. Arch Neurol. 1999;56(9):1098-1102. 321. Hahn C, Hill MD. Early Anti-coagulation after ischemic stroke due to atrial brillation is safe and prevents recurrent stroke. Can J Neurol Sci. 2015;42(2):92-95. 322. Hallevi H, Albright KC, Martin-Schild S, et al. Anticoagulation after cardioembolic stroke: to bridge or not to bridge? Arch Neurol. 2008;65(9):1169-1173. 323. Kim TH, Kim JY, Mun HS, et al. Heparin bridging in warfarin anticoagulation therapy initiation could increase bleeding in non- valvular atrial brillation patients: a multicenter propensity- matched analysis. J Thromb Haemost. 2015;13(2):182-190. 324. Audebert HJ, Schenk B, Tietz V, Schenkel J, Heuschmann PU. Initiation of oral anticoagulation after acute ischaemic stroke or transient ischaemic attack: timing and complications of overlapping heparin or conventional treatment. Cerebrovasc Dis. 2008;26(2): 171-177. 325. Seiffge DJ, Traenka C, Polymeris A, et al. Early start of DOAC after ischemic stroke: Risk of intracranial hemorrhage and recurrent events. Neurology. 2016;87(18):1856-1862. 326. Toyoda K, Arihiro S, Todo K, et al. Trends in oral anticoagulant choice for acute stroke patients with nonvalvular atrial brillation in Japan: the SAMURAI-NVAF study. Int J Stroke. 2015;10(6):836- 842. 327. Arihiro S, Todo K, Koga M, et al. Three-month risk-bene t pro le of anticoagulation after stroke with atrial brillation: the SAMURAI-Nonvalvular Atrial Fibrillation (NVAF) study. Int J Stroke. 2016;11(5):565-574. 328. Terent A, sberg S, Oldgren J, Hijazi Z, Norrving B. Antikoagulantia efter akut ischemisk stroke med f rmaks immer Fr gan om r tt tidpunkt f r ins ttning kr ver randomiserad klinisk pr vning [in Swedish]. Lakartidningen. 2016;113. 329. Hong KS, Choi YJ, Kwon SU; Triple AXEL Investigators. Rationale and design of Triple AXEL: trial for early anticoagulation in acute ischemic stroke patients with nonvalvular atrial brillation. Int J Stroke. 2015;10(1):128-133. 330. Lovelock CE, Molyneux AJ, Rothwell PM, Oxford Vascular S. Change in incidence and aetiology of intracerebral haemorrhage in Oxfordshire, UK, between 1981 and 2006: a population-based study. Lancet Neurol. 2007;6(6):487-493. 331. Horstmann S, Rizos T, Jenetzky E, Gumbinger C, Hacke W, Veltkamp R. Prevalence of atrial brillation in intracerebral hemorrhage. Eur J Neurol. 2014;21(4):570-576. 332. Chao TF, Liu CJ, Liao JN, et al. Use of oral anticoagulants for stroke prevention in patients with atrial brillation who have a history of intracranial hemorrhage. Circulation. 2016;133(16):1540-1547. 333. Poon MT, Fonville AF, Al-Shahi Salman R. Long-term prognosis after intracerebral haemorrhage: systematic review and meta- analysis. J Neurol Neurosurg Psychiatry. 2014;85(6):660-667. 334. Charidimou A, Schmitt A, Wilson D, et al. The Cerebral Haemorrhage Anatomical RaTing inStrument (CHARTS): development and assessment of reliability. J Neurol Sci. 2017;372: 178-183. 335. Knudsen KA, Rosand J, Karluk D, Greenberg SM. Clinical diagnosis of cerebral amyloid angiopathy: validation of the Boston criteria. Neurology. 2001;56(4):537-539. 336. Charidimou A, Imaizumi T, Moulin S, et al. Brain hemorrhage recurrence, small vessel disease type, and cerebral microbleeds: a meta-analysis. Neurology. 2017;89(8):820-829. 337. Wilson D, Charidimou A, Ambler G, et al. Recurrent stroke risk and cerebral microbleed burden in ischemic stroke and TIA: a meta-analysis. Neurology. 2016;87(14):1501-1510. 338. Wilson D, Werring DJ. Antithrombotic therapy in patients with cerebral microbleeds. Curr Opin Neurol. 2017;30(1):38-47. 339. Eckman MH, Rosand J, Knudsen KA, Singer DE, Greenberg SM. Can patients be anticoagulated after intracerebral hemorrhage? A decision analysis. Stroke. 2003;34(7):1710-1716. 340. Murthy SB, Gupta A, Merkler AE, et al. Restarting anticoagulant therapy after intracranial hemorrhage: a systematic review and meta-analysis. Stroke. 2017;48(6):1594-1600. 341. Orken DN, Kenangil G, Ozkurt H, et al. Prevention of deep venous thrombosis and pulmonary embolism in patients with acute intracerebral hemorrhage. Neurologist. 2009;15(6):329-331. 342. Dickmann U, Voth E, Schicha H, Henze T, Prange H, Emrich D. Heparin therapy, deep-vein thrombosis and pulmonary embolism after intracerebral hemorrhage. Klin Wochenschr. 1988;66(23): 1182-1183. 343. Majeed A, Kim YK, Roberts RS, Holmstrom M, Schulman S. Optimal timing of resumption of warfarin after intracranial hemorrhage. Stroke. 2010;41(12):2860-2866. 344. Wilson D, Seiffge DJ, Traenka C, et al. Outcome of intracerebral hemorrhage associated with different oral anticoagulants. Neurology. 2017;88(18):1693-1700. 345. Lewalter T, Kanagaratnam P, Schmidt B, et al. Ischaemic stroke prevention in patients with atrial brillation and high bleeding risk: opportunities and challenges for percutaneous left atrial appendage occlusion. Europace. 2014;16(5):626-630. 346. Boersma LV, Ince H, Kische S, et al. Ef cacy and safety of left atrial appendage closure with WATCHMAN in patients with or without contraindication to oral anticoagulation: 1-year follow-up outcome data of the EWOLUTION trial. Heart Rhythm. 2017;14(9):1302- 1308. 347. Renou P, Thambo JB, Iriart X, et al. Left Atrial Appendage Closure in Patients with Atrial Fibrillation and Previous Intracerebral Hemorrhage. J Stroke Cerebrovasc Dis. 2017;26(3):545-551. 348. Horstmann S, Zugck C, Krumsdorf U, et al. Left atrial appendage occlusion in atrial brillation after intracranial hemorrhage. Neurology. 2014;82(2):135-138. 349. Mineva PP, Manchev IC, Hadjiev DI. Prevalence and outcome of asymptomatic carotid stenosis: a population-based ultrasonographic study. Eur J Neurol. 2002;9(4):383-388. 350. Lehtola H, Airaksinen KEJ, Hartikainen P, et al. Stroke recurrence in patients with atrial brillation: concomitant carotid artery stenosis doubles the risk. Eur J Neurol. 2017;24(5):719-725. 351. Bonati LH, Dobson J, Featherstone RL, et al. Long-term outcomes after stenting versus endarterectomy for treatment of symptomatic carotid stenosis: the International Carotid Stenting Study (ICSS) randomised trial. Lancet. 2015;385(9967):529-538. 352. Saver JL. Cryptogenic stroke. N Engl J Med. 2016;375(11):e26. 353. Hart RG, Diener HC, Coutts SB, et al. Embolic strokes of undetermined source: the case for a new clinical construct. Lancet Neurol. 2014;13(4):429-438. 354. Hart RG, Catanese L, Perera KS, Ntaios G, Connolly SJ. embolic stroke of undetermined source: a systematic review and clinical update. Stroke. 2017;48(4):867-872. 355. Sposato LA, Cipriano LE, Saposnik G, Ruiz Vargas E, Riccio PM, Hachinski V. Diagnosis of atrial brillation after stroke and transient ischaemic attack: a systematic review and meta-analysis. Lancet Neurol. 2015;14(4):377-387. 356. Liao J, Khalid Z, Scallan C, Morillo C, O Donnell M. Noninvasive cardiac monitoring for detecting paroxysmal atrial brillation or utter after acute ischemic stroke: a systematic review. Stroke. 2007;38(11):2935-2940. 357. Sanna T, Diener HC, Passman RS, et al. Cryptogenic stroke and underlying atrial brillation. N Engl J Med. 2014;370(26):2478- 2486. 358. Gladstone DJ, Spring M, Dorian P, et al. Atrial brillation in patients with cryptogenic stroke. N Engl J Med. 2014;370(26):2467- 2477. 359. Lip GY, Hunter TD, Quiroz ME, Ziegler PD, Turakhia MP. Atrial brillation diagnosis timing, ambulatory ECG monitoring utilization, and risk of recurrent stroke. Circ Cardiovasc Qual Outcomes. 2017;10(1). 360. Afzal MR, Gunda S, Waheed S, et al. Role of outpatient cardiac rhythm monitoring in cryptogenic stroke: a systematic review and meta-analysis. Pacing Clin Electrophysiol. 2015;38(10):1236-1245. 361. Favilla CG, Ingala E, Jara J, et al. Predictors of nding occult atrial brillation after cryptogenic stroke. Stroke. 2015;46(5):1210-1215. 362. Ziegler PD, Glotzer TV, Daoud EG, et al. Detection of previously undiagnosed atrial brillation in patients with stroke risk factors and usefulness of continuous monitoring in primary stroke prevention. Am J Cardiol. 2012;110(9):1309-1314. 363. Healey JS, Alings M, Ha A, et al. Subclinical atrial brillation in older patients. Circulation. 2017;136(14):1276-1283. 364. Ntaios G, Lip GY, Makaritsis K, et al. CHADS(2), CHA(2)S(2) DS(2)-VASc, and long-term stroke outcome in patients without atrial brillation. Neurology. 2013;80(11):1009-1017. 365. Ntaios G, Papavasileiou V, Lip GY, et al. Embolic stroke of undetermined source and detection of atrial brillation on follow- up: how much causality is there? J Stroke Cerebrovasc Dis. 2016;25(12):2975-2980. 366. Ntaios G, Lip GYH, Vemmos K, et al. Age- and sex-speci c analysis of patients with embolic stroke of undetermined source. Neurology. 2017;89(6):532-539. 367. Gorenek B, Bax J, Boriani G, et al. Device-detected subclinical atrial tachyarrhythmias: de nition, implications and management-an European Heart Rhythm Association (EHRA) consensus document, endorsed by Heart Rhythm Society (HRS), Asia Paci c Heart Rhythm Society (APHRS) and Sociedad Latinoamericana de Estimulaci n Card aca y Electro siolog a (SOLEACE). Europace. 2017;19(9):1556-1578. 368. Boriani G, Pettorelli D. Atrial brillation burden and atrial brillation type: Clinical signi cance and impact on the risk of stroke and decision making for long-term anticoagulation. Vasc Pharmacol. 2016;83:26-35. 369. Mairesse GH, Moran P, Van Gelder IC, et al. Screening for atrial brillation: a European Heart Rhythm Association (EHRA) consensus document endorsed by the Heart Rhythm Society (HRS), Asia Paci c Heart Rhythm Society (APHRS), and Sociedad Latinoamericana de Estimulaci n Card aca y Electro siolog a (SOLAECE). Europace. 2017;19(10):1589-1623. 370. Freedman B, Camm J, Calkins H, et al. Screening for atrial brillation: a report of the AF-SCREEN International Collaboration. Circulation. 2017;135(19):1851-1867. 371. Healey JS, Connolly SJ, Gold MR, et al. Subclinical atrial brillation and the risk of stroke. N Engl J Med. 2012;366(2):120-129. 372. Freedman B, Boriani G, Glotzer TV, Healey JS, Kirchhof P, Potpara TS. Management of atrial high-rate episodes detected by cardiac implanted electronic devices. Nat Rev Cardiol. 2017;14(12): 701-714. 373. Boriani G, Valzania C, Bif M, Diemberger I, Ziacchi M, Martignani C. Asymptomatic lone atrial brillation how can we detect the arrhythmia? Curr Pharmaceut Design. 2015;21(5):659- 666. 374. Pollak WM, Simmons JD, Interian A, et al. Clinical utility of intraatrial pacemaker stored electrograms to diagnose atrial brillation and utter. Pacing Clin Electrophysiol. 2001;24(4 pt 1): 424-429. 375. Purerfellner H, Gillis AM, Holbrook R, Hettrick DA. Accuracy of atrial tachyarrhythmia detection in implantable devices with arrhythmia therapies. Pacing Clin Electrophysiol. 2004;27(7):983- 992. 376. Boriani G, Diemberger I, Ziacchi M, et al. AF burden is important fact or ction? Int J Clin Pract. 2014;68(4):444-452. 377. Boriani G, Padeletti L. Management of atrial brillation in bradyarrhythmias. Nat Rev Cardiol. 2015;12(6):337-349. 378. Zimetbaum P, Waks JW, Ellis ER, Glotzer TV, Passman RS. Role of atrial brillation burden in assessing thromboembolic risk. Circ Arrhythm Electrophysiol. 2014;7(6):1223-1229. 379. Swiryn S, Orlov MV, Benditt DG, et al. Clinical implications of brief device-detected atrial tachyarrhythmias in a cardiac rhythm management device population: results from the Registry of Atrial Tachycardia and Atrial Fibrillation Episodes. Circulation. 2016;134(16):1130-1140. 380. Glotzer TV, Hellkamp AS, Zimmerman J, et al. Atrial high rate episodes detected by pacemaker diagnostics predict death and stroke: report of the Atrial Diagnostics Ancillary Study of the 1198 Evidence-Based Medicine [ 1 5 4 # 5 C H E S T N O V E M B E R 2 0 1 8 ] MOde Selection Trial (MOST). Circulation. 2003;107(12):1614- 1619. 381. Capucci A, Santini M, Padeletti L, et al. Monitored atrial brillation duration predicts arterial embolic events in patients suffering from bradycardia and atrial brillation implanted with antitachycardia pacemakers. J Am Coll Cardiol. 2005;46(10):1913-1920. 382. Botto GL, Padeletti L, Santini M, et al. Presence and duration of atrial brillation detected by continuous monitoring: crucial implications for the risk of thromboembolic events. J Cardiovasc Electrophysiol. 2009;20(3):241-248. 383. Glotzer TV, Daoud EG, Wyse DG, et al. The relationship between daily atrial tachyarrhythmia burden from implantable device diagnostics and stroke risk: the TRENDS study. Circ Arrhythm Electrophysiol. 2009;2(5):474-480. 384. Shanmugam N, Boerdlein A, Proff J, et al. Detection of atrial high- rate events by continuous home monitoring: clinical signi cance in the heart failure-cardiac resynchronization therapy population. Europace. 2012;14(2):230-237. 385. Boriani G, Glotzer TV, Santini M, et al. Device-detected atrial brillation and risk for stroke: an analysis of >10,000 patients from the SOS AF project (Stroke preventiOn Strategies based on Atrial Fibrillation information from implanted devices). Eur Heart J. 2014;35(8):508-516. 386. Gonzalez M, Keating RJ, Markowitz SM, et al. Newly detected atrial high rate episodes predict long-term mortality outcomes in patients with permanent pacemakers. Heart Rhythm. 2014;11(12):2214- 2221. 387. Witt CT, Kronborg MB, Nohr EA, Mortensen PT, Gerdes C, Nielsen JC. Early detection of atrial high rate episodes predicts atrial brillation and thromboembolic events in patients with cardiac resynchronization therapy. Heart Rhythm. 2015;12(12): 2368-2375. 388. Van Gelder IC, Healey JS, Crijns HJGM, et al. Duration of device- detected subclinical atrial brillation and occurrence of stroke in ASSERT. Eur Heart J. 2017;38(17):1339-1344. 389. Boriani G, Botto GL, Padeletti L, et al. Improving stroke risk strati cation using the CHADS2 and CHA2DS2-VASc risk scores in patients with paroxysmal atrial brillation by continuous arrhythmia burden monitoring. Stroke. 2011;42(6):1768-1770. 390. Lopes RD, Alings M, Connolly SJ, et al. Rationale and design of the Apixaban for the Reduction of Thrombo-Embolism in Patients With Device-Detected Sub-Clinical Atrial Fibrillation (ARTESiA) trial. Am Heart J. 2017;189:137-145. 391. Kirchhof P, Blank BF, Calvert M, et al. Probing oral anticoagulation in patients with atrial high rate episodes: rationale and design of the Non-vitamin K antagonist Oral anticoagulants in patients with Atrial High rate episodes (NOAH-AFNET 6) trial. Am Heart J. 2017;190:12-18. 392. Seidl K, Hauer B, Schwick NG, Zellner D, Zahn R, Senges J. Risk of thromboembolic events in patients with atrial utter. Am J Cardiol. 1998;82(5):580-583. 393. Corrado G, Sgalambro A, Mantero A, et al. Thromboembolic risk in atrial utter. The FLASIEC (FLutter Atriale Societa Italiana di Ecogra a Cardiovascolare) multicentre study. Eur Heart J. 2001;22(12):1042-1051. 394. Padeletti L, P rerfellner H, Mont L, et al. New-generation atrial antitachycardia pacing (Reactive ATP) is associated with reduced risk of persistent or permanent atrial brillation in patients with bradycardia: results from the MINERVA randomized multicenter international trial. Heart Rhythm. 2015;12(8):1717-1725. 395. Vadmann H, Nielsen PB, Hjortsh j SP, et al. Atrial utter and thromboembolic risk: a systematic review. Heart. 2015;101(18): 1446-1455. 396. Morris JJ, Kong Y, North WC, Mcintosh HD. Experience with "cardioversion" of atrial brillation and utter. Am J Cardiol. 1964;14:94-100. 397. Jensen JB, Humphries JO, Kouwenhoven WB, Jude JR. Electroshock for atrial utter and atrial brillation. Follow-up studies on 50 patients. JAMA. 1965;194(11):1181-1184. 398. Wikland B, Edhag O, Eliasch H. Atrial brillation and utter treated with synchronized DC shock. A study on immediate and long-term results. Acta medica Scandinavica. 1967;182(5):665-671. 399. Bjerkelund C, Orning OM. An evaluation of DC shock treatment of atrial arrhythmias. Acta Med Scand. 1968;184(6):481-491. 400. Lanzarotti CJ, Olshansky B. Thromboembolism in chronic atrial utter: is the risk underestimated? J Am Coll Cardiol. 1997;30(6): 1506-1511. 401. Crijns HJ, Van Gelder IC, Tieleman RG, et al. Long-term outcome of electrical cardioversion in patients with chronic atrial utter. Heart. 1997;77(1):56-61. 402. Bertaglia E, D Este D, Franceschi M, Pascotto P. Cardioversion of persistent atrial utter in non-anticoagulated patients at low risk for thromboembolism. Italian Heart Journal. 2000;1(5):349-353. 403. Elhendy A, Gentile F, Khandheria BK, et al. Thromboembolic complications after electrical cardioversion in patients with atrial utter. Am J Med. 2001;111(6):433-438. 404. Scheuermeyer FX, Grafstein E, Heilbron B, Innes G. Emergency department management and 1-year outcomes of patients with atrial utter. Ann Emerg Med. 2011;57(6):564-571.e562. 405. Yadlapati A, Groh C, Passman R. Safety of short-term use of dabigatran or rivaroxaban for direct-current cardioversion in patients with atrial brillation and atrial utter. Am J Cardiol. 2014;113(8):1362-1363. 406. Santiago D, Warshofsky M, Li Mandri G, et al. Left atrial appendage function and thrombus formation in atrial brillation- utter: a transesophageal echocardiographic study. J Am Coll Cardiol. 1994;24(1):159-164. 407. Feltes TF, Friedman RA. Transesophageal echocardiographic detection of atrial thrombi in patients with non brillation atrial tachyarrhythmias and congenital heart disease. J Am Coll Cardiol. 1994;24(5):1365-1370. 408. Bikkina M, Alpert MA, Mulekar M, Shakoor A, Massey CV, Covin FA. Prevalence of intraatrial thrombus in patients with atrial utter. Am J Cardiol. 1995;76(3):186-189. 409. Grimm RA, Leung DY, Black IW, Stewart WJ, Thomas JD, Klein AL. Left atrial appendage "stunning" after spontaneous conversion of atrial brillation demonstrated by transesophageal Doppler echocardiography. Am Heart J. 1995;130(1):174-176. 410. Irani WN, Grayburn PA, Afridi I. Prevalence of thrombus, spontaneous echo contrast, and atrial stunning in patients undergoing cardioversion of atrial utter. A prospective study using transesophageal echocardiography. Circulation. 1997;95(4):962- 966. 411. Weiss R, Marcovitz P, Knight BP, et al. Acute changes in spontaneous echo contrast and atrial function after cardioversion of persistent atrial utter. Am J Cardiol. 1998;82(9):1052-1055. 412. Schmidt H, von der Recke G, Illien S, et al. Prevalence of left atrial chamber and appendage thrombi in patients with atrial utter and its clinical signi cance. J Am Coll Cardiol. 2001;38(3):778-784. 413. Gronefeld GC, Wegener F, Israel CW, Teupe C, Hohnloser SH. Thromboembolic risk of patients referred for radiofrequency catheter ablation of typical atrial utter without prior appropriate anticoagulation therapy. Pacing Clin Electrophysiol. 2003;26(1 pt 2): 323-327. 414. Parikh MG, Aziz Z, Krishnan K, Madias C, Trohman RG. Usefulness of transesophageal echocardiography to con rm clinical utility of CHA2DS2-VASc and CHADS2 scores in atrial utter. Am J Cardiol. 2012;109(4):550-555. 415. Alyeshmerni D, Pirmohamed A, Barac A, et al. Transesophageal echocardiographic screening before atrial utter ablation: is it necessary for patient safety? J Am Soc Echocardiogr. 2013;26(9): 1099-1105. 416. Wood KA, Eisenberg SJ, Kalman JM, et al. Risk of thromboembolism in chronic atrial utter. Am J Cardiol. 1997;79(8):1043-1047. 417. Regitz-Zagrosek V, Blomstrom Lundqvist C, Borghi C, et al. ESC Guidelines on the management of cardiovascular diseases during pregnancy: the Task Force on the Management of Cardiovascular Diseases during Pregnancy of the European Society of Cardiology (ESC). Eur Heart J. 2011;32(24):3147-3197. 418. Katsi V, Georgiopoulos G, Marketou M, et al. Atrial brillation in pregnancy: a growing challenge. Curr Med Res Opin. 2017;33(8): 1497-1504. 419. Ntusi NB, Badri M, Gumedze F, Sliwa K, Mayosi BM. Pregnancy- associated heart failure: a comparison of clinical presentation and outcome between hypertensive heart failure of pregnancy and idiopathic peripartum cardiomyopathy. PloS One. 2015;10(8): e0133466. 420. Lee MS, Chen W, Zhang Z, et al. Atrial brillation and atrial utter in pregnant women a population-based study. J Am Heart Assoc. 2016;5(4):e003182. 421. Bates SM, Greer IA, Middeldorp S, Veenstra DL, Prabulos AM, Vandvik PO. VTE, thrombophilia, antithrombotic therapy, and pregnancy: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest. 2012;141(2 Suppl):e691S-e736S. 422. Goland S, Elkayam U. Anticoagulation in pregnancy. Cardiol Clin. 2012;30(3):395-405. 423. Conti E, Zezza L, Ralli E, et al. Pulmonary embolism in pregnancy. J Thromb Thrombolysis. 2014;37(3):251-270. 424. Orme ML, Lewis PJ, de Swiet M, et al. May mothers given warfarin breast-feed their infants? Br Med J. 1977;1(6076):1564-1565. 425. McKenna R, Cole ER, Vasan U. Is warfarin sodium contraindicated in the lactating mother? J Pediatr. 1983;103(2):325-327. 426. Houwert-de Jong M, Gerards LJ, Tetteroo-Tempelman CA, de Wolff FA. May mothers taking acenocoumarol breast feed their infants? Eur J Clin Pharmacol. 1981;21(1):61-64. 427. Fondevila CG, Meschengieser S, Blanco A, Pe alva L, Lazzari MA. Effect of acenocoumarine on the breast-fed infant. Thrombosis Res. 1989;56(1):29-36. 428. Boriani G, Savelieva I, Dan GA, et al. Chronic kidney disease in patients with cardiac rhythm disturbances or implantable electrical devices: clinical signi cance and implications for decision making-a position paper of the European Heart Rhythm Association endorsed by the Heart Rhythm Society and the Asia Paci c Heart Rhythm Society. Europace. 2015;17(8):1169-1196. 429. Yang F, Hellyer JA, Than C, et al. Warfarin utilisation and anticoagulation control in patients with atrial brillation and chronic kidney disease. Heart. 2017;103(11):818-826. 430. McAlister FA, Wiebe N, Jun M, et al. Are Existing Risk Scores for Nonvalvular Atrial Fibrillation Useful for Prediction or Risk Adjustment in Patients With Chronic Kidney Disease? Can J Cardiol. 2017;33(2):243-252. 431. Chao TF, Liu CJ, Wang KL, et al. Incidence and prediction of ischemic stroke among atrial brillation patients with end-stage renal disease requiring dialysis. Heart Rhythm. 2014;11(10):1752- 1759. 432. Carrero JJ, Evans M, Szummer K, et al. Warfarin, kidney dysfunction, and outcomes following acute myocardial infarction in patients with atrial brillation. Jama. 2014;311(9):919-928. 433. Friberg L, Benson L, Lip GY. Balancing stroke and bleeding risks in patients with atrial brillation and renal failure: the Swedish Atrial Fibrillation Cohort study. Eur Heart J. 2015;36(5): 297-306. 434. Bonde AN, Lip GY, Kamper AL, et al. Net clinical bene t of antithrombotic therapy in patients with atrial brillation and chronic kidney disease: a nationwide observational cohort study. J Am Coll Cardiol. 2014;64(23):2471-2482. 435. Bonde AN, Lip GY, Kamper AL, et al. Effect of reduced renal function on time in therapeutic range among anticoagulated atrial brillation patients. J Am Coll Cardiol. 2017;69(6):752-753. 436. Harel Z, Chertow GM, Shah PS, et al. Warfarin and the risk of stroke and bleeding in patients with atrial brillation receiving dialysis: a systematic review and meta-analysis. Can J Cardiol. 2017;33(6):737-746. 437. Lau YC, Proietti M, Guiducci E, Blann AD, Lip GY. Atrial brillation and thromboembolism in patients with chronic kidney disease. J Am Coll Cardiol. 2016;68(13):1452-1464. 438. Molteni M, Polo Friz H, Primitz L, Marano G, Boracchi P, Cimminiello C. The de nition of valvular and non-valvular atrial brillation: results of a physicians survey. Europace. 2014. 439. Authors/Task Force m, Elliott PM, Anastasakis A, et al. 2014 ESC Guidelines on diagnosis and management of hypertrophic cardiomyopathy: the Task Force for the Diagnosis and Management of Hypertrophic Cardiomyopathy of the European Society of Cardiology (ESC). Eur Heart J. 2014;35(39):2733-2779. 440. Eikelboom JW, Connolly SJ, Brueckmann M, et al. Dabigatran versus warfarin in patients with mechanical heart valves. N Engl J Med. 2013;369(13):1206-1214. 441. Pokorney SD, Rao MP, Wojdyla DM, et al. Abstract 17277: apixaban use in patients with atrial brillation with bioprosthetic valves: insights from ARISTOTLE. Circulation. 2015;132(suppl 3). A17277-A17277. 442. Carnicelli AP, De Caterina R, Halperin JL, et al. Edoxaban for the prevention of thromboembolism in patients with atrial brillation and bioprosthetic valves. Circulation. 2017;135(13):1273-1275. 443. Petronio AS, Capranzano P, Barbato E, et al. Current status of transcatheter mitral valve therapy in Europe: results from an EAPCI survey (Part II). EuroIntervention. 2017;12(16):1934-1939. 444. De Caterina R, John Camm A. Non-vitamin K antagonist oral anticoagulants in atrial brillation accompanying mitral stenosis: the concept for a trial. Europace. 2016;18(1):6-11. 445. Blackshear JL, Odell JA. Appendage obliteration to reduce stroke in cardiac surgical patients with atrial brillation. Ann Thoracic Surg. 1996;61(2):755-759. 446. Reddy VY, Sievert H, Halperin J, et al. Percutaneous left atrial appendage closure vs warfarin for atrial brillation: a randomized clinical trial. JAMA. 2014;312(19):1988-1998. 447. Reddy VY, Doshi SK, Sievert H, et al. Percutaneous left atrial appendage closure for stroke prophylaxis in patients with atrial brillation: 2.3-Year Follow-up of the PROTECT AF (Watchman Left Atrial Appendage System for Embolic Protection in Patients with Atrial Fibrillation) Trial. Circulation. 2013;127(6):720-729. 448. Reddy VY, Holmes D, Doshi SK, Neuzil P, Kar S. Safety of percutaneous left atrial appendage closure: results from the Watchman Left Atrial Appendage System for Embolic Protection in Patients with AF (PROTECT AF) clinical trial and the Continued Access Registry. Circulation. 2011;123(4):417-424. 449. Main ML, Fan D, Reddy VY, et al. Assessment of device-related thrombus and associated clinical outcomes with the WATCHMAN left atrial appendage closure device for embolic protection in patients with atrial brillation (from the PROTECT-AF Trial). Am J Cardiol. 2016;117(7):1127-1134. 450. Holmes DR, Doshi SK, Kar S, et al. Left atrial appendage closure as an alternative to warfarin for stroke prevention in atrial brillation: a patient-level meta-analysis. J Am Coll Cardiol. 2015;65(24):2614-2623. 451. Holmes DR, Kar S, Price MJ, et al. Prospective randomized evaluation of the Watchman Left Atrial Appendage Closure device in patients with atrial brillation versus long-term warfarin therapy: the PREVAIL trial. J Am Coll Cardiol. 2014;64(1):1-12. 452. Holmes DR, Reddy VY, Turi ZG, et al. Percutaneous closure of the left atrial appendage versus warfarin therapy for prevention of stroke in patients with atrial brillation: a randomised non- inferiority trial. Lancet. 2009;374(9689):534-542. 453. Masoudi FA, Calkins H, Kavinsky CJ, et al. 2015 ACC/HRS/SCAI left atrial appendage occlusion device societal overview. Heart Rhythm. 2015;12(10):e122-e136. 454. Park JW, Bethencourt A, Sievert H, et al. Left atrial appendage closure with Amplatzer cardiac plug in atrial brillation: initial European experience. Catheter Cardiovasc Interv. 2011;77(5):700- 706. 455. Gloekler S, Shakir S, Doblies J, et al. Early results of rst versus second generation Amplatzer occluders for left atrial appendage closure in patients with atrial brillation. Clin Res Cardiol. 2015;104(8):656-665. 1200 Evidence-Based Medicine [ 1 5 4 # 5 C H E S T N O V E M B E R 2 0 1 8 ] 456. Tereshchenko LG, Henrikson CA, Cigarroa J, Steinberg JS. Comparative effectiveness of interventions for stroke prevention in atrial brillation: a network meta-analysis. J Am Heart Assoc. 2016;5(5). 457. Gianni C, Di Biase L, Trivedi C, et al. Clinical implications of leaks following left atrial appendage ligation with the LARIAT device. JACC Cardiovasc Interv. 2016;9(10):1051-1057. 458. Fauchier L, Cinaud A, Brigadeau F, et al. Device-related thrombosis after percutaneous left atrial appendage occlusion for atrial brillation. J Am Coll Cardiol. 2018;71(14):1528-1536. 459. Dukkipati SR, Kar S, Holmes DR, Jr., et al. Device-related thrombus after left atrial appendage closure: incidence, predictors, and outcomes [published online ahead of print May 11, 2018]. 090. 460. Aryana A, Singh SK, Singh SM, et al. Association between incomplete surgical ligation of left atrial appendage and stroke and systemic embolization. Heart Rhythm. 2015;12(7):1431-1437. 461. Kanderian AS, Gillinov AM, Pettersson GB, Blackstone E, Klein AL. Success of surgical left atrial appendage closure: assessment by transesophageal echocardiography. J Am Coll Cardiol. 2008;52(11):924-929. 462. Healey JS, Crystal E, Lamy A, et al. Left Atrial Appendage Occlusion Study (LAAOS): results of a randomized controlled pilot study of left atrial appendage occlusion during coronary bypass surgery in patients at risk for stroke. Am Heart J. 2005;150(2):288- 293. 463. Whitlock RP, Vincent J, Blackall MH, et al. Left Atrial Appendage Occlusion Study II (LAAOS II). Can J Cardiol. 2013;29(11):1443-1447. 464. Boriani G, Bif M, Diemberger I, Cervi E, Martignani C. Peri- operative management of patients taking antithrombotic therapy: need for an integrated proactive approach. Int J Clin Pract. 2011;65(3):236-239. 465. Douketis JD, Spyropoulos AC, Spencer FA, et al. Perioperative management of antithrombotic therapy: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest. 2012;141(2 Suppl):e326S-e350S. 466. Ruff CT, Ansell JE, Becker RC, et al. North American Thrombosis Forum, AF Action Initiative Consensus Document. Am J Med. 2016;129(suppl 5):S1-S29. 467. Aliot E, Breithardt G, Brugada J, et al. An international survey of physician and patient understanding, perception, and attitudes to atrial brillation and its contribution to cardiovascular disease morbidity and mortality. Europace. 2010;12(5):626-633. 468. Dantas GC, Thompson BV, Manson JA, Tracy CS, Upshur RE. Patients perspectives on taking warfarin: qualitative study in family practice. BMC Family Practice. 2004;5:15. 469. Lane DA, Ponsford J, Shelley A, Sirpal A, Lip GY. Patient knowledge and perceptions of atrial brillation and anticoagulant therapy: effects of an educational intervention programme. The West Birmingham Atrial Fibrillation Project. Int J Cardiol. 2006;110(3):354-358. 470. Lip GY, Agnelli G, Thach AA, Knight E, Rost D, Tangelder MJ. Oral anticoagulation in atrial brillation: a pan-European patient survey. Eur J Intern Med. 2007;18(3):202-208. 471. Lip GY, Kamath S, Jafri M, Mohammed A, Bareford D. Ethnic differences in patient perceptions of atrial brillation and anticoagulation therapy: the West Birmingham Atrial Fibrillation Project. Stroke. 2002;33(1):238-242. 472. McCabe PJ, Schad S, Hampton A, Holland DE. Knowledge and self-management behaviors of patients with recently detected atrial brillation. Heart Lung. 2008;37(2):79-90. 473. Frankel DS, Parker SE, Rosenfeld LE, Gorelick PB. HRS/NSA 2014 survey of atrial brillation and stroke: gaps in knowledge and perspective, opportunities for improvement. J Stroke Cerebrovasc Dis. 2015;24(8):1691-1700. 474. Fuller R, Dudley N, Blacktop J. Risk communication and older people-understanding of probability and risk information by medical inpatients aged 75 years and older. Age Ageing. 2001;30(6):473-476. 475. Fuller R, Dudley N, Blacktop J. Avoidance hierarchies and preferences for anticoagulation semi-qualitative analysis of older patients views about stroke prevention and the use of warfarin. Age Ageing. 2004;33(6):608-611. 476. Lane DA, Barker RV, Lip GY. Best practice for atrial brillation patient education. Curr Pharm Des. 2015;21(5):533-543. 477. McCabe PJ. What patients want and need to know about atrial brillation. J Multidisciplinary Healthcare. 2011;4:413-419. 478. Pandya EY, Bajorek B. Factors Affecting patients perception on, and adherence to, anticoagulant therapy: anticipating the role of direct oral anticoagulants. Patient. 2017;10(2):163-185. 479. Kirchhof P. The future of atrial brillation management: integrated care and strati ed therapy. Lancet. 2017;390(10105):1873-1887. 480. Hendriks JM, Crijns HJ, Tieleman RG, Vrijhoef HJ. The atrial brillation knowledge scale: development, validation and results. Int J Cardiol. 2013;168(2):1422-1428. 481. Desteghe L, Engelhard L, Raymaekers Z, et al. Knowledge gaps in patients with atrial brillation revealed by a new validated knowledge questionnaire. Int J Cardiol. 2016;223:906-914. 482. Heidbuchel H, Berti D, Campos M, et al. Implementation of non- vitamin K antagonist oral anticoagulants in daily practice: the need for comprehensive education for professionals and patients. Thrombosis Journal. 2015;13:22. 483. Bakhai A, Sandberg A, Mittendorf T, et al. Patient perspective on the management of atrial brillation in ve European countries. BMC Cardiovasc Dis. 2013;13:108.