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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

Acute stroke management in patients with known or suspected atrial fibrillation

Jennifer L Mandzia1, Michael D Hill

  • 1Calgary Stroke Program, Department of Clinical Neurosciences, Hotchkiss Brain Institute, University of Calgary, 1403 29th St NW, Calgary, Alberta, Canada.

The Canadian Journal of Cardiology
|June 25, 2013
PubMed

Insights

Atrial fibrillation (AF) increases stroke risk, particularly in older adults. New oral anticoagulants offer benefits but require specific management strategies for stroke patients.

Area of Science:

  • Neurology
  • Cardiology
  • Pharmacology

Background:

  • Atrial fibrillation (AF) is a significant cause of ischemic stroke, leading to severe outcomes, especially in the elderly.
  • AF-related strokes are frequently large and associated with high mortality rates.
  • Newer oral anticoagulants present advantages over warfarin but introduce complex management challenges.

Purpose of the Study:

  • To review and discuss the management of anticoagulation in patients with acute ischemic stroke and atrial fibrillation.
  • To address the unique aspects of anticoagulation management during the hyperacute and acute phases of stroke.
  • To provide guidance on managing intracranial hemorrhage in anticoagulated patients.

Main Methods:

  • Review of current literature and clinical guidelines regarding anticoagulation in AF patients experiencing stroke.
  • Discussion of treatment options for acute ischemic stroke in anticoagulated individuals.
  • Analysis of anticoagulation discontinuation and initiation timing with various oral anticoagulants.

Main Results:

  • Acute stroke management is not altered by AF, but anticoagulation management requires specific protocols.
  • New oral anticoagulants offer improved safety and dosing profiles compared to warfarin.
  • Strategies for managing intracranial hemorrhage in anticoagulated patients are crucial.

Conclusions:

  • Optimal management of anticoagulation is essential for AF patients experiencing ischemic stroke.
  • Understanding the nuances of old and new oral anticoagulants is critical for effective patient care.
  • Further investigation into cardioembolic stroke workup in AF patients is warranted.

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