Stroke and thromboembolism prevention in atrial fibrillation

Area of Science:

• Cardiology
• Thrombosis Management
• Medical Device Innovation

Background:

• Atrial fibrillation (AF) management prioritizes preventing stroke and systemic thromboembolism.
• Current guidelines recommend risk assessment models for stratifying AF patients.
• Vitamin K antagonists (VKAs) and direct oral anticoagulants (DOACs) are primary therapies, with left atrial appendage occluding devices as alternatives.

Purpose of the Study:

• To review current strategies for stroke and thromboembolism prevention in atrial fibrillation.
• To discuss anticoagulation management during cardioversion and AF ablation.
• To highlight evolving therapeutic approaches and areas requiring further investigation.

Main Methods:

• Review of existing risk assessment models for stroke in AF.
• Analysis of current anticoagulation therapies (VKAs, DOACs) and devices.
• Examination of peri-procedural anticoagulation management protocols for cardioversion and ablation.

Main Results:

• Risk stratification tools guide anticoagulation decisions for AF patients.
• Uninterrupted VKA and DOAC therapy during AF ablation reduces thromboembolic risk without increasing major bleeding.
• Ongoing research explores minimally interrupted anticoagulation and wearable monitor integration.

Conclusions:

• Effective anticoagulation strategies are crucial for managing AF-related thromboembolic risk.
• Device-based therapies and refined peri-procedural management offer alternative or adjunctive options.
• Future research should focus on optimizing anticoagulation delivery and integrating new technologies in AF care.