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Updated: Sep 3, 2026

The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation
23:33

The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation

Published on: February 28, 2012

Atrial fibrillation: epidemiology and the risk and prevention of stroke

J M Kalman1, A M Tonkin

  • 1Austin Hospital, Heidelberg, Victoria, Australia.

Pacing and Clinical Electrophysiology : PACE
|September 1, 1992
PubMed

Insights

Atrial fibrillation increases stroke risk, particularly in nonrheumatic cases. Warfarin prophylaxis is now supported by recent studies for these patients, though aspirin

Area of Science:

  • Cardiology
  • Neurology
  • Epidemiology

Background:

  • Atrial fibrillation (AF) incidence rises with age, with congestive cardiac failure, coronary artery disease, and hypertension now more commonly associated than rheumatic heart disease.
  • Nonrheumatic AF significantly elevates ischemic stroke risk (approx. 5-fold) and yearly stroke risk (5-7%), increasing with age.
  • AF is linked to silent cerebral infarction and increased mortality, but its independent association with stroke risk remains debated.

Purpose of the Study:

  • To review the evolving understanding of atrial fibrillation (AF) and its associated conditions.
  • To evaluate the evidence supporting preventive therapies for stroke in nonrheumatic AF.
  • To discuss risk stratification and the role of antithrombotic prophylaxis in AF management.

Main Methods:

  • Review of recent prospective randomized studies on warfarin prophylaxis in nonrheumatic AF.
  • Analysis of epidemiological data on AF prevalence and associated cardiovascular conditions.
  • Synthesis of literature regarding stroke risk, silent cerebral infarction, and mortality in AF patients.

Main Results:

  • Four recent prospective randomized studies provide clear support for warfarin prophylaxis in nonrheumatic AF.
  • Identification of high- and low-risk subgroups within nonrheumatic AF patients may guide prophylaxis decisions.
  • Contradictory findings persist in the literature regarding risk stratification and the role of aspirin for prophylaxis.

Conclusions:

  • Warfarin prophylaxis is recommended for nonrheumatic atrial fibrillation based on current evidence.
  • Further research is needed to clarify risk stratification and the role of aspirin in AF stroke prevention.

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