Atrial fibrillation (AF) significantly increases stroke risk, with affected individuals having a fivefold higher likelihood compared to the general population. Oral anticoagulation (OAC), particularly with direct oral anticoagulants (DOACs) [1], is the primary method for stroke prevention in clinical AF due to its superior efficacy, safety, and ease of use. However, stroke prevention in patients with device-detected subclinical atrial fibrillation (SCAF) remains debated. SCAF, detected through implanted cardiac devices like pacemakers or defibrillators, involves brief, asymptomatic AF episodes and carries a lower stroke risk than clinical AF, raising questions about the benefits of anticoagulation in this group, particularly due to bleeding risks.
