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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 and cardiembolic stroke. Treatment and issue in acute phase]

Masahiro Yasaka1

  • 1Cerebrovascular Medicine, Kyushu Medical Center.

Rinsho Shinkeigaku = Clinical Neurology
|January 27, 2012
PubMed

Insights

For acute cardioembolic stroke, consider intravenous thrombolysis with rt-PA, brain protection, and edema treatment. Immediate anticoagulation requires careful risk-benefit assessment, with heparin often used alongside warfarin but not typically with dabigatran.

Area of Science:

  • Neurology
  • Cardiology
  • Pharmacology

Context:

  • Acute cardioembolic stroke management requires a multi-faceted approach.
  • Timely interventions are critical in the acute phase of stroke.

Purpose:

  • To outline current therapeutic considerations for acute cardioembolic stroke.
  • To discuss the role and timing of thrombolysis and anticoagulation.

Summary:

  • Recommended treatments include rt-PA intravenous thrombolysis (within 3 hours if eligible), intra-arterial thrombolysis, neuroprotection with edaravone, and glycerol for cerebral edema.
  • Immediate anticoagulation efficacy is not fully established and necessitates individual risk-benefit evaluation.
  • When initiating warfarin, concurrent heparin is advised until therapeutic anticoagulation is achieved; dabigatran, having rapid action, often obviates the need for heparin.

Impact:

  • Provides a concise overview of acute cardioembolic stroke treatment options.
  • Highlights the nuanced decision-making process for anticoagulation in this patient group.
  • Informs clinical practice regarding the use of thrombolytics and anticoagulants.

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