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How can asymptomatic atrial fibrillation be managed?

This Premium Q&A, reviewed and published, features a real conversation between an iCliniq user and a physician.

Patient's Query

Hello doctor,

I have asymptomatic atrial fibrillation (AF) and vascular dementia.

Please help.

Answered by Dr. Sagar Ramesh Makode

Hello,

Welcome to icliniq.com.

Please attach your ECG (electrocardiogram) along with additional information.

Regards.

Patient's Query

Hello doctor,

Thank you for the reply,

These ECGs will be from the AliveCor KardiaBand, recorded for continuous, beat-to-beat monitoring. I would like to send more of these rhythm strips in the future. Occasionally, when the watch sensor shifts, it can sometimes suggest T waves that may not actually be present. I have also noticed that some of these ECGs show only a few irregular AFib rhythms, resembling isolated pulse periods from an old MI.

Please advise.

Answered by Dr. Sagar Ramesh Makode

Hello,

Welcome back to icliniq.com.

I have reviewed all your tracings (attachment removed to protect patient identity), and they show atrial fibrillation with a controlled ventricular rate, likely due to age-related changes. AFib (atrial fibrillation) is common in older adults. There are no Q waves in any of the tracings. Some nonspecific T wave inversions are present in certain leads, though they are not definitive for suggesting ischemia. Therefore, there are no significant Q waves, T wave inversions, or any indications of an old MI. However, since this is just a single-lead recording, the information is limited. If you have a 12-lead ECG, please attach it.

You may continue taking Sotalol as prescribed. However, for older patients with AFib, it is generally recommended to perform additional tests, such as an echocardiogram and a stress test, to rule out ischemia. AFib can increase the risk of clot formation and stroke, so the decision about blood thinners should be re-evaluated, provided there are no contraindications. Please discuss this with your cardiologist.

I hope this helps; feel free to reach out if you have any questions.

Thank you.

Answered byDr. Sagar Ramesh Makode

Medically reviewed byDr. K. Shobana

Published At May 21, 2018
Reviewed AtDecember 9, 2025

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Dr. Sagar Ramesh Makode

Cardiology

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