Bruton's tyrosine kinase inhibitors (BTKis) have reshaped the therapeutic landscape of B cell malignancies, significantly improving survival outcomes [1]. However, cardiovascular side effects, particularly atrial fibrillation (AF), have long been recognized [2,3], especially in patients receiving first-generation drugs [4]. While the prevalence and incidence of symptomatic AF are well studied in the general population [5], asymptomatic or subclinical AF remains an overlooked issue because of its diagnostic challenge, and its clinical implications regarding thrombo-haemorrhagic risk.
