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Updated: Aug 5, 2025
The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation
Published on: February 28, 2012
Atrial fibrillation: Primary prevention, secondary prevention, and prevention of thromboembolic complications: Part 2
Richard G Trohman1, Henry D Huang1, Parikshit S Sharma1
1Section of Electrophysiology, Division of Cardiology, Department of Internal Medicine, Rush University Medical Center, Chicago, IL, United States.
Insights
Atrial fibrillation (AF) is a growing concern, especially in aging populations. This review explores current strategies for AF prevention and managing its complications, including stroke prevention.
Area of Science:
- Cardiology
- Public Health
Background:
- Atrial fibrillation (AF) is the most common cardiac arrhythmia, associated with significant morbidity and mortality.
- Aging populations worldwide are experiencing a rapid increase in individuals aged 65 years and older.
- The prevalence of AF is projected to increase by over 60% by 2050, posing a substantial public health challenge.
Purpose of the Study:
- To review current strategies for the primary and secondary prevention of atrial fibrillation.
- To compare non-invasive and invasive treatment approaches for reducing AF recurrence.
- To examine pharmacological, device-based, and surgical methods for preventing thromboembolic events, particularly stroke.
Main Methods:
- A narrative review facilitated by a comprehensive search of MEDLINE and other scholarly databases.
- Inclusion of peer-reviewed clinical trials, randomized controlled trials, meta-analyses, and relevant studies published between 1950 and 2021.
- Keywords used included "atrial fibrillation," "primary prevention," "stroke prevention," "anticoagulation," and various ablation techniques.
Main Results:
- While progress has been made, primary prevention, secondary prevention, and prevention of thromboembolic complications in AF remain areas for continued development.
- Various treatment strategies exist, encompassing pharmacological, percutaneous device, and surgical interventions.
- Both non-invasive and invasive methods are employed to manage AF recurrence and prevent associated risks.
Conclusions:
- Effective management of atrial fibrillation requires a multifaceted approach, addressing prevention, recurrence, and thromboembolic risk.
- Ongoing research and clinical advancements are crucial for improving patient outcomes and reducing the growing burden of AF.
- A comprehensive understanding of available treatment options is essential for clinicians managing patients with AF.
Abstract:
Atrial fibrillation (AF), the most common sustained cardiac arrhythmia, once thought to be benign as long as the ventricular rate was controlled, is associated with significant cardiac morbidity and mortality. Increasing life expectancy driven by improved health care and decreased fertility rates has, in most of the world, resulted in the population aged ≥65 years growing more rapidly than the overall population. As the population ages, projections suggest that the burden of AF may increase more than 60% by 2050. Although considerable progress has been made in the treatment and management of AF, primary prevention, secondary prevention, and prevention of thromboembolic complications remain a work in progress. This narrative review was facilitated by a search of MEDLINE to identify peer-reviewed clinical trials, randomized controlled trials, meta-analyses, and other clinically relevant studies. The search was limited to English-language reports published between 1950 and 2021. Atrial fibrillation was searched using the terms primary prevention, hyperthyroidism, Wolff-Parkinson-White syndrome, catheter ablation, surgical ablation, hybrid ablation, stroke prevention, anticoagulation, left atrial occlusion and atrial excision. Google and Google scholar as well as bibliographies of identified articles were reviewed for additional references. In these two manuscripts, we discuss the current strategies available to prevent AF, then compare non-invasive and invasive treatment strategies to diminish AF recurrence. In addition, we examine the pharmacological, percutaneous device and surgical approaches to prevent stroke as well as other types of thromboembolic events.
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