DGK-Positionspapier zum Umgang mit Device-detektiertem Vorhofflimmern (DDAF): Aus der Kommission für Klinische Kardiovaskuläre Medizin

Tobias Tönnis; Ralf Birkemeyer; David Duncker; Lars Eckardt; Klaus Groeschel; Dominik Linz; Christian Meyer; Sergio Richter; Florian Straube; Arian Sultan; Rolf Wachter; Paulus Kirchhof; Maura M. Zylla

doi:10.1007/s12181-025-00750-y

DGK-Positionspapier zum Umgang mit Device-detektiertem Vorhofflimmern (DDAF): Aus der Kommission für Klinische Kardiovaskuläre Medizin

Translated title of the contribution: Position paper of the German Cardiac Society (DGK) on dealing with device-detected atrial fibrillation (DDAF): From the Committee for Clinical Cardiovascular Medicine

Tobias Tönnis^*, Ralf Birkemeyer, David Duncker, Lars Eckardt, Klaus Groeschel, Dominik Linz, Christian Meyer, Sergio Richter, Florian Straube, Arian Sultan, Rolf Wachter, Paulus Kirchhof, Maura M. Zylla

^*Corresponding author for this work

Research output: Contribution to journal › (Systematic) Review article › peer-review

Abstract

Device-detected atrial fibrillation (DDAF) occurs in many patients with implanted cardiac pacemakers, defibrillators, devices for cardiac resynchronization treatment and event recorders. These are short, mostly asymptomatic episodes of atrial fibrillation. In episodes with a duration of more than 5-6 min artefacts are very unlikely. The DDAF is associated with an increased risk of thromboembolic events. The effectiveness and safety of oral anticoagulation for DDAF were investigated in two large randomized studies (NOAH-AFNET 6 and ARTESIA [1, 2]). Fortunately, a low rate of ischemic stroke without anticoagulation (ca. 1%/years) was found in both studies. With therapeutic anticoagulation this can be somewhat reduced but severe bleeding becomes more frequent. The preventive effect of early rhythm-maintaining treatment on stroke suggests that the low atrial load in DDAF correlates with the low stroke rate. This position paper of the German Cardiac Society (DGK) presents the current data situation and formulates expert recommendations for the treatment of patients with DDAF.

Translated title of the contribution	Position paper of the German Cardiac Society (DGK) on dealing with device-detected atrial fibrillation (DDAF): From the Committee for Clinical Cardiovascular Medicine
Original language	German
Pages (from-to)	270-284
Number of pages	15
Journal	Die Kardiologie
Volume	19
Issue number	4
Early online date	2025
DOIs	https://doi.org/10.1007/s12181-025-00750-y
Publication status	Published - Aug 2025

Keywords

Atrial fibrillation
Anticoagulation
Heart and brain
Cardiac pacemaker
Implantable cardioverter defibrillator
CATHETER ABLATION
STROKE
TRIAL
ANTICOAGULATION
PROGRESSION
PREVENTION
RISK

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10.1007/s12181-025-00750-y

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Tönnis, T., Birkemeyer, R., Duncker, D., Eckardt, L., Groeschel, K., Linz, D., Meyer, C., Richter, S., Straube, F., Sultan, A., Wachter, R., Kirchhof, P., & Zylla, M. M. (2025). DGK-Positionspapier zum Umgang mit Device-detektiertem Vorhofflimmern (DDAF): Aus der Kommission für Klinische Kardiovaskuläre Medizin. Die Kardiologie, 19(4), 270-284. https://doi.org/10.1007/s12181-025-00750-y

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title = "DGK-Positionspapier zum Umgang mit Device-detektiertem Vorhofflimmern (DDAF): Aus der Kommission f{\"u}r Klinische Kardiovaskul{\"a}re Medizin",

abstract = "Device-detected atrial fibrillation (DDAF) occurs in many patients with implanted cardiac pacemakers, defibrillators, devices for cardiac resynchronization treatment and event recorders. These are short, mostly asymptomatic episodes of atrial fibrillation. In episodes with a duration of more than 5-6 min artefacts are very unlikely. The DDAF is associated with an increased risk of thromboembolic events. The effectiveness and safety of oral anticoagulation for DDAF were investigated in two large randomized studies (NOAH-AFNET 6 and ARTESIA [1, 2]). Fortunately, a low rate of ischemic stroke without anticoagulation (ca. 1\%/years) was found in both studies. With therapeutic anticoagulation this can be somewhat reduced but severe bleeding becomes more frequent. The preventive effect of early rhythm-maintaining treatment on stroke suggests that the low atrial load in DDAF correlates with the low stroke rate. This position paper of the German Cardiac Society (DGK) presents the current data situation and formulates expert recommendations for the treatment of patients with DDAF.",

keywords = "Atrial fibrillation, Anticoagulation, Heart and brain, Cardiac pacemaker, Implantable cardioverter defibrillator, CATHETER ABLATION, STROKE, TRIAL, ANTICOAGULATION, PROGRESSION, PREVENTION, RISK",

author = "Tobias T{\"o}nnis and Ralf Birkemeyer and David Duncker and Lars Eckardt and Klaus Groeschel and Dominik Linz and Christian Meyer and Sergio Richter and Florian Straube and Arian Sultan and Rolf Wachter and Paulus Kirchhof and Zylla, \{Maura M.\}",

year = "2025",

month = aug,

doi = "10.1007/s12181-025-00750-y",

language = "German",

volume = "19",

pages = "270--284",

journal = "Die Kardiologie",

issn = "2731-7129",

publisher = "Springer Medizin",

number = "4",

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Tönnis, T, Birkemeyer, R, Duncker, D, Eckardt, L, Groeschel, K, Linz, D, Meyer, C, Richter, S, Straube, F, Sultan, A, Wachter, R, Kirchhof, P & Zylla, MM 2025, 'DGK-Positionspapier zum Umgang mit Device-detektiertem Vorhofflimmern (DDAF): Aus der Kommission für Klinische Kardiovaskuläre Medizin', Die Kardiologie, vol. 19, no. 4, pp. 270-284. https://doi.org/10.1007/s12181-025-00750-y

TY - JOUR

T1 - DGK-Positionspapier zum Umgang mit Device-detektiertem Vorhofflimmern (DDAF)

T2 - Aus der Kommission für Klinische Kardiovaskuläre Medizin

AU - Tönnis, Tobias

AU - Birkemeyer, Ralf

AU - Duncker, David

AU - Eckardt, Lars

AU - Groeschel, Klaus

AU - Linz, Dominik

AU - Meyer, Christian

AU - Richter, Sergio

AU - Straube, Florian

AU - Sultan, Arian

AU - Wachter, Rolf

AU - Kirchhof, Paulus

AU - Zylla, Maura M.

PY - 2025/8

Y1 - 2025/8

N2 - Device-detected atrial fibrillation (DDAF) occurs in many patients with implanted cardiac pacemakers, defibrillators, devices for cardiac resynchronization treatment and event recorders. These are short, mostly asymptomatic episodes of atrial fibrillation. In episodes with a duration of more than 5-6 min artefacts are very unlikely. The DDAF is associated with an increased risk of thromboembolic events. The effectiveness and safety of oral anticoagulation for DDAF were investigated in two large randomized studies (NOAH-AFNET 6 and ARTESIA [1, 2]). Fortunately, a low rate of ischemic stroke without anticoagulation (ca. 1%/years) was found in both studies. With therapeutic anticoagulation this can be somewhat reduced but severe bleeding becomes more frequent. The preventive effect of early rhythm-maintaining treatment on stroke suggests that the low atrial load in DDAF correlates with the low stroke rate. This position paper of the German Cardiac Society (DGK) presents the current data situation and formulates expert recommendations for the treatment of patients with DDAF.

AB - Device-detected atrial fibrillation (DDAF) occurs in many patients with implanted cardiac pacemakers, defibrillators, devices for cardiac resynchronization treatment and event recorders. These are short, mostly asymptomatic episodes of atrial fibrillation. In episodes with a duration of more than 5-6 min artefacts are very unlikely. The DDAF is associated with an increased risk of thromboembolic events. The effectiveness and safety of oral anticoagulation for DDAF were investigated in two large randomized studies (NOAH-AFNET 6 and ARTESIA [1, 2]). Fortunately, a low rate of ischemic stroke without anticoagulation (ca. 1%/years) was found in both studies. With therapeutic anticoagulation this can be somewhat reduced but severe bleeding becomes more frequent. The preventive effect of early rhythm-maintaining treatment on stroke suggests that the low atrial load in DDAF correlates with the low stroke rate. This position paper of the German Cardiac Society (DGK) presents the current data situation and formulates expert recommendations for the treatment of patients with DDAF.

KW - Atrial fibrillation

KW - Anticoagulation

KW - Heart and brain

KW - Cardiac pacemaker

KW - Implantable cardioverter defibrillator

KW - CATHETER ABLATION

KW - STROKE

KW - TRIAL

KW - ANTICOAGULATION

KW - PROGRESSION

KW - PREVENTION

KW - RISK

U2 - 10.1007/s12181-025-00750-y

DO - 10.1007/s12181-025-00750-y

M3 - (Systematic) Review article

SN - 2731-7129

VL - 19

SP - 270

EP - 284

JO - Die Kardiologie

JF - Die Kardiologie

IS - 4

ER -

DGK-Positionspapier zum Umgang mit Device-detektiertem Vorhofflimmern (DDAF): Aus der Kommission für Klinische Kardiovaskuläre Medizin

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Keywords

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