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The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation
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The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation

Published on: February 28, 2012

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An Update on Anticoagulation in Atrial Fibrillation

John Amerena1, Daryl Ridley2

  • 1Deakin University, Geelong, Vic, Australia.

Heart, Lung & Circulation
|July 8, 2017
PubMed

Insights

Direct-acting oral anticoagulants (DOACs) offer a new approach to preventing strokes in atrial fibrillation (AF) patients. DOACs are expected to become the primary stroke prevention therapy for non-valvular AF.

Area of Science:

  • Cardiology
  • Neurology
  • Pharmacology

Background:

  • Atrial fibrillation (AF) increases stroke risk, necessitating anticoagulation.
  • Warfarin was the standard anticoagulant for stroke prevention in AF.
  • Novel direct-acting oral anticoagulants (DOACs) have emerged as alternatives.

Purpose of the Study:

  • To discuss the paradigm shift in anticoagulation therapy for AF.
  • To highlight the role of DOACs in stroke prevention.
  • To guide physicians on current anticoagulation strategies for AF.

Main Methods:

  • Review of current anticoagulation guidelines and clinical evidence.
  • Comparison of warfarin with DOACs for stroke prevention in AF.
  • Analysis of treatment philosophy changes in AF management.

Main Results:

  • DOACs represent a significant advancement in stroke prevention for AF.
  • The focus of treatment decisions is shifting from 'when to use' to 'when not to use' anticoagulation.
  • Warfarin remains relevant for specific patient subgroups.

Conclusions:

  • DOACs are poised to become the predominant therapy for stroke prevention in non-valvular AF.
  • Physicians must adapt to new treatment algorithms considering DOACs.
  • Anticoagulation management in AF has entered a new era with DOAC availability.

Keywords:
AnticoagulationAtrial fibrillationNovel anticoagulantsWarfarin

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