SINGLE-AF \u2014 DOAC for AF With a Single Stroke Risk Factor<\/p>\n
Sources: Heart, October 1, 2026; NEJM; ESC 2026.<\/p>\n
\u2022\u2060 \u20601,803 patients with AF and CHA\u2082DS\u2082-VA = 1 \u2192 DOAC vs no anticoagulation.
\n\u2022\u2060 \u2060Primary outcome at 24 months: 0.5% vs 1.5% (4 vs 13 events).
\n\u2022\u2060 \u2060Stroke: 0.15%\/yr vs 0.55%\/yr (3 vs 10 strokes).
\n\u2022\u2060 \u2060Major bleeding: low in both groups; too few events for a reliable bleeding estimate.
\n\u2022\u2060 \u2060AF burden matters: 72% had paroxysmal AF and 31% had prior AF ablation \u2192 relatively low AF burden may partly explain the low absolute stroke rate.
\n\u2022\u2060 \u2060AF burden = how much AF occurs over time (duration\/frequency or % of monitored time in AF), not simply AF present\/absent.
\n\u2022\u2060 \u2060Device-detected AF: very short\/low-burden episodes carry lower absolute stroke risk than sustained clinical AF; randomized data such as ARTESiA show a modest stroke reduction with apixaban but increased major bleeding.
\n\u2022\u2060 \u2060Clinical message: CHA\u2082DS\u2082-VA = 1 \u2192 DOAC may be considered\/encouraged, but AF burden can refine the decision; very low burden may favor no OAC in selected patients.<\/p>\n