Stroke Prevention In Atrial Fibrillation

It is an evident fact that patients with AF are at a higher risk of developing ischemic stroke, and therefore preventive measures are necessary. The purpose of this article is to discuss various strategies that should be individualized for stroke prevention in AF focusing on such aspects as risk assessment, anticoagulation treatment, and non-pharmacological management. To attain the findings of this report, a detailed analysis of the studies conducted in recent years has been carried out using the data obtained from the Euro Heart Survey, systematic reviews, and meta-analyses. These studies demonstrate variations regarding stroke risk stratification schemes, the management outcomes of anticoagulation treatments, including warfarin and direct oral anticoagulants (DOACs), and the new technique of left atrial appendage occlusion (LAAO). The outcome of the study highlights that while anticoagulation remains the primary method for the prevention of stroke, individual management that reflects patients' characteristics and preferences, is vital. Clinician-patient decision aids have the potential to improve patient activation in the management of prevention regimens. Furthermore, the actual evidence has indicated that DOACs are less likely to cause intracranial hemorrhage compared to vitamin-K antagonists but equally effective in preventing ischemic strokes. This article also discusses the last developments in the catheter ablation of AF and its possible application in stroke prevention. This review provides suggestions for future studies and clinical practice, by pointing out the importance of the combination of multidisciplinary teamwork and continuous evaluation of prevention strategies

کلیدواژه ها:

Atrial Fibrillation ، Stroke Prevention ، Anticoagulation ، Risk Stratification ، Catheter Ablation