Is Secondary Atrial Fibrillation Different? Or Is Atrial Fibrillation Just Atrial Fibrillation?
Bibliographic record
Abstract
Secondary atrial fibrillation (AF) is self-limited AF associated with an acute reversible precipitant. About 1/3 of all Framingham Heart Study patients with first-detected AF had a potentially reversible, precipitant. There are limited reports assessing outcomes of secondary AF and risks to established primary AF remain unclear. Evidence-based recommendations to guide management of these patients are limited and prior studies suggests practice patterns are different in secondary AF. In this review, we summarize the current evidence on risks of AF recurrence, ischemic stroke and outcomes of anticoagulation in secondary AF, compared to primary AF. We provide an overview and recommend management approach in monitoring for AF recurrence and thromboembolic prophylaxis in these patients. Self-limited or transient atrial fibrillation (AF) occurring during an acute reversible precipitant has been referred to as secondary AF, 1 temporary cause of AF, 2 and AF occurring transiently during stress. 3 Alternatively, it has been classified as either ‘reversible’ or ‘provoked’ AF, varying in terms of the underlying cardiac substrate and risk for AF recurrence. 4 Given it was described in prior American Heart Association / American College of Cardiology / Heart Rhythm Society guidelines, 1 we continue using the defining term ‘secondary AF’. In this article, we review prior studies and provide an overview of long-term management approaches to secondary AF. We will use the term ‘primary AF’ to describe established AF, without an associated secondary precipitant.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.011 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.004 |
| Scholarly communication | 0.003 | 0.005 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.003 | 0.004 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".