Management of asymptomatic arrhythmias: a European Heart Rhythm Association (EHRA) consensus document, endorsed by the Heart Failure Association (HFA), Heart Rhythm Society (HRS), Asia Pacific Heart Rhythm Society (APHRS), Cardiac Arrhythmia Society of Southern Africa (CASSA), and Latin America Heart Rhythm Society (LAHRS)

David O Arnar; Georges H Mairesse; Giuseppe Boriani; Hugh Calkins; Ashley Chin; Andrew Coats; Jean-Claude Deharo; Jesper Hastrup Svendsen; Hein Heidbüchel; Rodrigo Isa; Jonathan M Kalman; Deirdre A Lane; Ruan Louw; Gregory Y H Lip; Philippe Maury; Tatjana Potpara; Frederic Sacher; Prashanthan Sanders; Niraj Varma; Laurent Fauchier; ESC Scientific Document Group; EHRA Scientific Documents Committee

doi:10.1093/europace/euz046

Management of asymptomatic arrhythmias: a European Heart Rhythm Association (EHRA) consensus document, endorsed by the Heart Failure Association (HFA), Heart Rhythm Society (HRS), Asia Pacific Heart Rhythm Society (APHRS), Cardiac Arrhythmia Society of Southern Africa (CASSA), and Latin America Heart Rhythm Society (LAHRS)

Europace. 2019 Mar 18;21(6):844–845. doi: 10.1093/europace/euz046.

Authors

David O Arnar¹, Georges H Mairesse², Giuseppe Boriani³, Hugh Calkins⁴, Ashley Chin⁵, Andrew Coats⁶, Jean-Claude Deharo⁷, Jesper Hastrup Svendsen^{8

9}, Hein Heidbüchel¹⁰, Rodrigo Isa¹¹, Jonathan M Kalman^{12

13}, Deirdre A Lane^{14

15}, Ruan Louw¹⁶, Gregory Y H Lip^{14

15}, Philippe Maury¹⁷, Tatjana Potpara¹⁸, Frederic Sacher¹⁹, Prashanthan Sanders²⁰, Niraj Varma²¹, Laurent Fauchier²²; ESC Scientific Document Group; EHRA Scientific Documents Committee

Affiliations

¹ Department of Medicine, Landspitali - The National University Hospital of Iceland and University of Iceland, Reykjavik, Iceland.
² Department of Cardiology, Cliniques du Sud-Luxembourg, Arlon, Belgium.
³ Division of Cardiology, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, Modena, Italy.
⁴ Department of Arrhythmia Services, Johns Hopkins Medical Institutions Baltimore, MD, USA.
⁵ Division of Cardiology, Department of Medicine, Groote Schuur Hospital and University of Cape Town, Cape Town, South Africa.
⁶ Department of Cardiology, University of Warwick, Warwickshire, UK.
⁷ Department of Rhythmology, Hôpital Universitaire La Timone, Marseille, France.
⁸ Department of Cardiology, The Heart Centre, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
⁹ Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
¹⁰ Antwerp University Hospital, University of Antwerp, Edegem, Belgium.
¹¹ Clínica RedSalud Vitacura and Hospital el Carmen de Maipú, Santiago, Chile.
¹² Department of Cardiology, Royal Melbourne Hospital, Melbourne, VIC, Australia.
¹³ Department of Medicine, University of Melbourne, Melbourne, VIC, Australia.
¹⁴ Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, UK.
¹⁵ Aalborg Thrombosis Research Unit, Aalborg University, Aalborg, Denmark.
¹⁶ Department Cardiology (Electrophysiology), Mediclinic Midstream Hospital, Centurion, South Africa.
¹⁷ Cardiology, University Hospital Rangueil, Toulouse, France.
¹⁸ Cardiology Clinic, Clinical Center of Serbia, School of Medicine, University of Belgrade, Serbia.
¹⁹ Service de Cardiologie, Institut Lyric, CHU de Bordeaux, Bordeaux, France.
²⁰ Centre for Heart Rhythm Disorders, South Australian Health and Medical Research Institute, University of Adelaide and Royal Adelaide Hospital, Adelaide, South Australia, Australia.
²¹ Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, OH, USA.
²² Service de Cardiologie et Laboratoire d'Electrophysiologie Cardiaque, Centre Hospitalier Universitaire Trousseau et Université François Rabelais, Tours, France.

PMID: 30882141
DOI: 10.1093/europace/euz046

Abstract

Asymptomatic arrhythmias are frequently encountered in clinical practice. Although studies specifically dedicated to these asymptomatic arrhythmias are lacking, many arrhythmias still require proper diagnostic and prognostic evaluation and treatment to avoid severe consequences, such as stroke or systemic emboli, heart failure, or sudden cardiac death. The present document reviews the evidence, where available, and attempts to reach a consensus, where evidence is insufficient or conflicting.

Keywords: Arrhythmias; Asymptomatic; Asystole; Atrial fibrillation; Atrial tachyarrhythmias; Bradycardia; Extrasystoles; Heart failure; Stroke; Tachycardia-induced cardiomyopathy; Ventricular tachycardia; Wolff–Parkinson–White syndrome.