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When you identify new atrial fibrillation in a hospitalized patient that spontaneously converts to sinus rhythm within 24–48 hours, and the patient has a CHA₂DS₂-VASc score of 2–3, how do you decide whether to initiate anticoagulation and/or discharge with a wearable cardiac monitor?

Emerging data from the NEJM Clinician 2025 year-in-review highlight the high stroke risk associated with transient hospital-onset atrial fibrillation.
1 Answer
Mednet Member
Mednet MemberInvited Expert
Hospital Medicine · UT Health San Antonio
Answered on · Updated on

This is a tough one.

I think the easier part is who should get a wearable cardiac monitor? I think the answer is pretty much everyone since the recurrence rate is around 30% in one year - and if it recurs, it predisposes to strokes, and I'd likely provide anticoagulation per AHA/ACC based on CHA₂DS₂...

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