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Updated: May 24, 2026
23:33
The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation
Published on: February 28, 2012
[Atrial fibrillation in an acute stroke unit]
Elsa Melki1, Jérôme Mawet, Mariana Sarov-Riviere
1Neurologie, Hôpital Lariboisière, 2, rue Ambroise Paré--75010 Paris.
Bulletin De L'Academie Nationale De Medecine
|March 2, 2012
Summary
Patients with atrial fibrillation (AF) and stroke are older, have more risk factors, and present unique treatment challenges compared to typical AF patients. Their complex profiles necessitate careful consideration for anticoagulation and stroke management.
Area of Science:
- Neurology
- Cardiology
- Stroke Medicine
Background:
- Limited research exists on patients experiencing stroke associated with atrial fibrillation (AF).
- Existing studies often focus on AF management or new oral anticoagulants, neglecting AF-stroke patient cohorts.
Purpose of the Study:
- To characterize patients with AF-associated stroke admitted to stroke units.
- To identify challenges in managing these complex patients and inform future treatment strategies.
Main Methods:
- Prospective study of 50 patients with AF and stroke over 4 months (Nov 2010-Mar 2011).
- Included cerebral infarcts (CI), transient ischemic attacks (TIA), and intracerebral hemorrhage (ICH).
- Literature review of sparse relevant studies on AF-stroke patients.
Main Results:
- AF-stroke patients are older, more frequently female, and have numerous vascular risk factors and cerebrovascular diseases.
- Cerebral infarcts are often extensive and hemorrhagic; AF is frequently discovered upon stroke unit admission.
- Underuse of Vitamin K antagonists (VKA) is noted; rtPA thrombolysis is common.
- Treatment is complicated by history of ICH and dual risk of embolic recurrence and hemorrhagic transformation.
Conclusions:
- Patients with AF in stroke units differ significantly from those seen by cardiologists, presenting complex management issues.
- High prevalence of comorbidities and contraindications to long-term anticoagulation pose treatment challenges.
- Emerging oral anticoagulants will likely face similar dilemmas in this high-risk population.
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