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Anticoagulation in atrial fibrillation and flutter

M F Scholten1, A S Thornton, J M Mekel

  • 1Department of Clinical Electrophysiology, Thoraxcentre, Erasmus University Medical Centre, Rotterdam, The Netherlands. m.f.scholten@erasmusmc.nl

Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology
|August 10, 2005
PubMed

Insights

Atrial fibrillation and atrial flutter increase stroke risk. This review covers thromboembolism, risk assessment, and anticoagulation strategies, including around procedures like catheter ablation.

Area of Science:

  • Cardiology
  • Neurology
  • Thrombosis Research

Background:

  • Atrial fibrillation and atrial flutter are significant risk factors for ischemic stroke.
  • Thromboembolism originating from the atria poses a major clinical challenge.

Purpose of the Study:

  • To review the pathogenesis of thromboembolism in atrial arrhythmias.
  • To discuss risk assessment and current anticoagulation strategies.
  • To provide guidance on anticoagulation management around procedures like catheter ablation and cardioversion.

Main Methods:

  • Comprehensive literature search on atrial fibrillation, atrial flutter, and stroke.
  • Synthesis of evidence regarding thromboembolism pathogenesis and risk stratification.
  • Analysis of anticoagulation efficacy and alternative therapies.

Main Results:

  • Established link between atrial arrhythmias and increased stroke risk.
  • Identified key factors for thromboembolic risk assessment.
  • Evaluated efficacy of various anticoagulation therapies and alternatives.
  • Highlighted complexities of anticoagulation around procedures.

Conclusions:

  • Effective anticoagulation is crucial for stroke prevention in patients with atrial fibrillation and atrial flutter.
  • Tailored anticoagulation strategies are necessary for procedures like catheter ablation and cardioversion.
  • A suggested anticoagulation strategy for pulmonary vein ablation is proposed.

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