Atrial fibrillation burden: an update-the need for a CHA2DS2-VASc-AFBurden score

Atrial fibrillation (AF) is an established independent risk factor for stroke. Current guidelines regard AF as binary; either present or absent, with the decision for anti-coagulation driven by clinical variables alone. However, there are increasing data to support a biological gradient of AF burden and stroke risk, both in clinical and non-clinical AF phenotypes. As such, this raises the concept of combining AF burden assessment with a clinical risk score to refine and individualize the assessment of stroke risk in AF-the CHA(2)DS(2)VASc-AFBurden score. We review the published data supporting a biological gradient to try and construct a putative schema of risk attributable to AF burden.

Automated summary

Atrial fibrillation (AF) burden may exhibit a biological gradient with stroke risk, suggesting that different levels of AF burden could impact the risk of stroke in patients. Combining AF burden assessment with clinical risk scoring can help refine the assessment of stroke risk in AF patients.